Adrian Charles, Disna Abeysuriya, Mitali N Fadia, Gretchen Pomare, Jane E Dahlstrom
Placental assessment following a stillbirth is a crucial investigation. It helps identify possible causes or contributing factors to stillbirth. It can help evaluate the risk of recurrence in future pregnancies and may indicate whether further tests are needed. It also provides guidance for managing subsequent pregnancies. In this review, we discuss practical considerations in placental assessment following stillbirth, including how both pre-analytical and analytical factors can influence the assessment. We outline the changes that occur in the placenta after stillbirth and explain how to distinguish these changes from antemortem placental pathology known to cause stillbirth. In addition, we highlight incidental findings and artefacts in the placenta that can be confused with true pathology. Finally, we address current controversies, identify areas for future research, and propose a practical approach to assessing the placenta in cases of stillbirth.