Why should the placenta be inspected by a pathologist after a traumatic birth?

After a traumatic birth, the placenta should be inspected by a pathologist to check for any evidence of an abnormality to the placenta, such as an infection to the placenta, and whether there is any meconium discoloration of the placenta.  The placental pathologist will inspect the placenta for signs of chronic deprivation, such as abnormalities caused by infection of the placenta.

Meconium discoloration of the placenta can be a sign of fetal distress just before birth and a sign that the baby's oxygen supply was compromised.  Meconium is the green viscous fluid that consists of fetal gastrointestinal secretions and meconium passage occurs in up to 20% of full-term gestations. Meconium passage occurs as a result of three distinct mechanisms: (1) as a physiologic maturation event; (2) as a response to acute hypoxic events; and (3) as a response to chronic intrauterine hypoxia.  Infants with acute hypoxia events, near and after the onset of labor, are more likely to pass thick meconium and to have a meconium stained placenta; the consistency of meconium is divided into two categories: thin meconium and thick or particulate meconium.

The placental pathologist will examined the length of the umbilical cord; the normal range for the length of an umbilical cord is greater than 30 centimeters and less than 75 centimeters.  An umbilical cord typically has a median length of 57.5 centimeters and has three blood vessels (two arteries and one vein). A short umbilical cord (30 centimeters or less) or a long umbilical cord (110 centimeters) can be associated with neonatal problems.  Sometimes the umbilical cord is abnormally short at birth because the cord is cut at birth and the placental pathologist does not have the umbilical cord in its entirety.

An abnormally short umbilical cord can be caused by neurodevelopmental syndromes.  Fetal movements increase the length of the umbilical cord and if the umbilical cord is short, there is a presumption that the baby did not move in utero.

The placental pathologist will check the weight of the placenta and compare the weight of the placenta to the birth weight of the baby.  If the weight of the placenta is within a normal range (approximately 500 grams is normal), then it would be expected that the baby's condition at birth is unrelated to any abnormality of the placenta.

The infant's placenta should always be examined by a placental pathologist in cases involving traumatic deliveries, i.e., cases where the baby needs resuscitation at birth.  The pathologist's microscopic and gross inspection of the placenta will help you prove that you baby did not have any chronic or long-standing problems before labor and delivery.  This will help you prove that the lack of oxygen to your baby just before delivery is the cause of the baby's brain damage and developmental problems.