Gross Examination

  • Cynthia KaplanEmail author


The gross examination of the placenta is a critical element in proper evaluation. Issues of fixation are discussed both before and after gross examination. A detailed methodology of sequential examination is presented with details of creating membrane rolls. While most placentas can be studied using four blocks with cord, membranes and two to three sections of villous tissue, placentas with gross abnormalities often require more. It is very important to see villous tissue from “normal”-appearing areas away from and uninvolved by pathologic processes.


Macroscopic examination Membrane roll Fixation of the placenta Blocking of the placenta 


  1. 1.
    Benirschke K, Burton G, Baergen R. Pathology of the human placenta. 6th ed. Berlin, Heidelberg: Springer Verlag; 2012. p. 1–11.CrossRefGoogle Scholar
  2. 2.
    Kaplan C. Gross examination of the placenta. Surg Pathol Clin. 2013;6:1–26.CrossRefGoogle Scholar
  3. 3.
    Jaiman S. Gross examination of the placenta and its importance in evaluating an unexplained intrauterine fetal demise. J Fetal Med. 2015;2:113–20.CrossRefGoogle Scholar
  4. 4.
    Woodling BA, Kroener JM, Puffer HW, et al. Gross examination of the placenta. Clin Obstet Gynecol. 1976;191:21–44.CrossRefGoogle Scholar
  5. 5.
    Earn AA. Macroscopic examination of the placenta. Can Med Assoc J. 1950;62:602–204.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Thornburg KL, Marshall N. The placenta is the center of the chronic disease universe. Am J Obstet Gynecol. 2015;213:S14–20.CrossRefGoogle Scholar
  7. 7.
    Altemani A, Gonzatti A, Metze K. Letter to the editor: how many paraffin blocks are necessary to detect villitis? Placenta. 2003;24:116–7.CrossRefGoogle Scholar
  8. 8.
    Khong TY, Mooney EE, Ariel I, et al. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med. 2016;140:698–713.CrossRefGoogle Scholar
  9. 9.
    Walford N, Htun K, Akhilesh M. Detection of atherosis in preeclamptic placentas: comparison of two gross sampling protocols. Pediatr Dev Pathol. 2005;8:61–5.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Anatomic Pathology, Medical School at State University of New York at Stony BrookUniversity Hospital Level IIStony BrookUSA

Personalised recommendations