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    Products of conception

    Background

    A range of fragmented endometrial specimens are received in the laboratory; diagnostic curettings and biopsies, products of conception from simple incomplete or complete abortions and post-partum retained products.1,2

    This protocol includes products of conception. A separate protocol is provided for endometrial curettings.


    Record the patient identifying information and any clinical information supplied together with the specimen description as designated on the container. See overview page for more detail on identification principles.

    • No
      • Non-routine fixation (not formalin), describe.
    • Yes
      • Special studies required, describe.
      • Ensure samples are taken prior to fixation.

    Fresh specimens may require cytogenetic studies for the investigation of repeated miscarriages or suspected molar pregnancy.

    Specimens should be strained through a sieve to ensure all tissue is collected.

    See general information for more detail on specimen handling procedures.

    Inspect the specimen and dictate a macroscopic description.


    External Inspection

    Describe the following features of the specimen:

    Procedure

    Describe as stated by the clinician.

    • Products of conception
    • Post-partum retained products
    • Other, specify

    Specimen volume1

    • Measure aggregate size in three dimensions (mm)

    Specimen description if relevant

    • Colour
    • Consistency
    • Vesicles, if present record diameter (mm)
    • Blood clots
    • Polyps

    Identifiable products of conception

    • Absent
    • Present

    Record the presence of:

    • Chorionic villi
    • Membranes
    • Gestational sac and contents
    • Fetal parts. If identified, measure foot length (mm) if possible.
    • Fat

    Dissection

    Not required.


    Internal Inspection

    Not required.


    Processing

    Submit representative tissue including placental tissue and membranes. One or two blocks may suffice for confirmation of normal products of conception. Further blocks may be required if the initial section has failed to confirm intrauterine pregnancy or there is a suspicion of trophoblastic disease or malignancy.

    Transfer directly into cassettes for processing. Lens paper, biopsy pads or similar are required to prevent loss of tissue during processing.

    Check the pot carefully, particularly the lid and around the rim so that all fragments of tissue are found.

    Be aware that blood clot and mucus may not survive processing.

    Record details of each cassette.

    An illustrated block key similar to the one provided may be useful.

    Block allocation key

    Cassette id
    Site
    No. of pieces
    A-B
    Products of conception
     
     

    Acknowlegements

    Drs Kerryn Ireland-Jenkin and Marsali Newman for their contribution in reviewing and editing this protocol.


    References

    1. Brown L, Andrew A, Hirschowitz L and Millan D. Tissue pathways for gynaecological pathology, The Royal College of Pathologists, London, 2008.
    2. Heatley MK. Dissection and reporting of the organs of the female genital tract. J Clin Pathol 2008;61(3):241-257.

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      POC

      Products of conception

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      25-Mar-2019
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