Version May 2024
| Sample pathologist's dictation for the pathology report of a singleton placenta: |
| The specimen was received fresh, labeled with the patient's name and unit number, and consists of a singleton placenta. |
| Cord insertion ________________ cm from margin (or ________________ cm in membranes from margin). |
| Cord length ________________ cm, cord diameter ________________ cm, total number of coils ________________, direction of coils ________________ (left or right). |
| Number of vessels ________________. |
| Other cord findings ________________ (torsion, abnormal color, nodules, masses, etc). |
| Cord color ________________ (white, yellow, green, brown, etc). |
| Membranes inserted ________________ % (marginally, circummarginately, circumvallate). |
| Membrane color ________________. |
| Other membrane findings ________________ (nodules, hemorrhage, membranous vessels, etc). |
| The trimmed placental weight is ________________ grams. |
| Disk measurement ________________ cm in greatest diameter and ________________ cm thick. |
| Fetal surface findings ________________ (nodules, masses, chorionic vascular thromboses, etc). |
| Maternal surface ________________ (complete, disrupted, masses, calcification, fibrin, hematomas, indentations, etc). |
| Parenchyma ________________ (normal = beefy, spongy, red; lesions = number, size, percent of mass involved, location). |
| Gross summary: |
| Placenta ________________ grams, approximately ________________ percentile for ________________ weeks gestational age with ________________. |
Cassette key:
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| Sample pathologist's dictation for the pathology report of a twin placenta: |
| The specimen was received fresh, labeled with the patient's name and unit number, is a fused/separate twin placenta, oriented/not oriented to birth order by cord clamps. (If fused – the vascular equator divides the placenta mass ________________ % to twin A and ________________ % to twin B. There are/are not surface vascular anastomoses [review with staff and describe if anastomoses are present – A-A, V-V, A-V direction]. The dividing membrane is thin/thick and clear/cloudy.) |
| If separate placentas, describe each separately using singleton template. If fused, use: |
| Twin A: |
| One cord clamp, ________________ % of the fused disk mass. |
| Cord insertion ________________ cm from margin (or ________________ cm in membranes from margin). |
| Cord length ________________ cm, cord diameter ________________ cm, total number of coils ________________, direction of coils ________________ (left or right). |
| Number of vessels ________________. |
| Other cord findings ________________ (torsion, abnormal color, nodules, masses, etc). |
| Cord color ________________ (white, yellow, green, brown, etc). |
| Membranes inserted ________________ % (marginally, circummarginately, circumvallate). |
| Membrane color ________________. |
| Other membrane findings _______________ (nodules, hemorrhage, membranous vessels, etc). |
| Fetal surface findings ________________ (nodules, masses, chorionic vascular thromboses, etc). |
| Maternal surface ________________ (complete, disrupted, masses, calcification, fibrin, hematomas, indentations, etc). |
| Parenchyma ________________ (normal = beefy, spongy, red; lesions = number, size, percent of mass involved, location). |
| Twin B: |
| Two cord clamps, ________________ % of the fused disk mass. |
| Cord insertion ________________ cm from margin (or ________________ cm in membranes from margin). |
| Cord length ________________ cm, cord diameter ________________ cm, total number of coils ________________, direction of coils ________________ (left or right). |
| Number of vessels ________________. |
| Other cord findings ________________ (torsion, abnormal color, nodules, masses, etc). |
| Cord color ________________ (white, yellow, green, brown, etc). |
| Membranes inserted ________________ % (marginally, circummarginately, circumvallate). |
| Membrane color ________________. |
| Other membrane findings ________________ (nodules, hemorrhage, membranous vessels, etc). |
| Fetal surface findings ________________ (nodules, masses, chorionic vascular thromboses, etc). |
| Maternal surface ________________ (complete, disrupted, masses, calcification, fibrin, hematomas, indentations, etc). |
| Parenchyma ________________ (normal = beefy, spongy, red; lesions = number, size, percent of mass involved, location). |
| Disk: |
| The trimmed fused placental weight is ________________ grams. |
| Disk measurement ________________ cm in greatest diameter and ________________ cm thick. |
| Gross summary: |
| Fused/separate twin placentas ________________ grams, approximately ________________ percentile for ________________ weeks gestational age with ________________. |
Cassette key:
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