Neonatologist responsibility to ensure placentas are received for pathologic examination-response to comment on criteria for placental examination for obstetric and neonatal providers.

We thank Bellini et al for their interest in our manuscript describing the benefits of and triage criteria for full pathologic examination of the placenta. We agree whole-heartedly with the authors on the necessity of having a perinatal pathologist analyze placental pathology samples of all neonates admitted to the neonatal intensive care unit (NICU) from both in-house deliveries and transfers from outside hospitals. We also recommend that transferred neonates should come with their placenta, if possible, or if the placenta was examined by pathologists at the birth hospital, the remaining unsampled tissue should be sent along with a set of the slides created at the birthing hospital for analysis by a perinatal pathologist at the host NICU hospital. Many of the authors of this manuscript have protocols and arrangements with regional sites to ensure that this occurs. We agree that the responsibility to ensure that the placenta is submitted with a newborn transfer generally lies with the referring neonatologist. These authors also make the excellent suggestion to use barcode labels to link the placenta to the infant. However, in the United States, the placenta is linked to the mother for insurance purposes, but this alternative approach would solve many problems. Optimally, the placental pathology report should be available in both the mother’s and the infant’s medical records. For many of us, this was expedited by creating a link between the maternal and neonatal records in the electronic medical record. For tracking purposes, a barcode is a great idea, but it may be less practical for billing and reporting. Alternatively, the placental pathology report should, at a minimum, be sent to the neonatologist overseeing the neonate in the NICU for referral. Again, we thank the authors for their interest in our manuscript, for their kind words, and for their suggestions. Criteria for placental examination for obstetrical and neonatal providers: a commentAmerican Journal of Obstetrics & GynecologyVol. 228Issue 6PreviewWe have read with interest the very important article by Roberts et al.1 The clinical benefits and triage recommendations described for the examination of the pathologic placenta provide an absolute guideline. We have read this excellent article from the side of the neonatologist. We strongly agree with the recommended neonatal triage that the authors described in Table 2 of their article, indicating the need for a pathologic examination of the placenta. We would like to make a brief observation. Full-Text PDF