title: Pathologic examination of the placenta and its clinical utility: a survey of obstetrics and gynecology providers.
abstract: OBJECTIVE
  To determine provider awareness of the College of American Pathologists (CAP) recommended guidelines for examination of placenta and evaluate the Obstetrician -Gynecologist's perception of the clinical utility of placenta pathology reports.
  
  
  METHODS
  An anonymous survey of Obstetrician Gynecologists who attended the national conference of The Central Association of Obstetricians and Gynecologists (CAOG) in 2013 assessing their knowledge of the CAP guidelines and utilization of information obtained from pathology reports. Chi-square or Fisher's exact test were used to evaluate association between specialists and non-specialist providers as related to survey questions and multivariable logistic regression used to explore factors associated with utilization and awareness of the guidelines.
  
  
  RESULTS
  A total of 218 providers attended the conference and 111 surveys were completed. Only 36% of participants were aware of the CAP guidelines for pathologic examination of the placenta. The odds that a physician with more than 15 years of experience will send a placenta for examination was 0.210 times that of physicians with less than 15 years of experience (CI 0.084, 0.521). The odds for awareness of the CAP guideline among subspecialists who participated in the study were 3.630 times the odds for non-specialist (CI 1.44, 9.147). In addition, the odds of sending a placenta for those physicians in a community hospital are 0.300 times that of physicians in a University hospital (CI 0.110, 0.820). The presence of a pathologist skilled in obstetrics and gynecology did not seem to affect awareness of the CAP guidelines, perception of the usefulness of the guidelines and likelihood of sending a placenta for examination. Only 21% of participants reported understanding the nomenclature used in pathology reports "all the time". Participants ranked the explanation of adverse pregnancy outcome as the most useful clinical application of placenta pathologic examination and most advocated for continued placental pathologic examination.
  
  
  CONCLUSIONS
  Most of the participants in this study were not aware of the CAP guidelines. The study also revealed deficits in understanding the nomenclature on pathology reports even though providers overall recognized the clinical utility of pathologic examination of the placenta. This emphasizes the importance of actively incorporating the concept of pathologic changes of the placenta into the curriculum for training obstetrician gynecologists and pathologists and for institutions to streamline policies centered on pathologic examination of the placenta.
authors.affiliation: a Department of Obstetrics and Gynecolog and.
authors.forename: Imelda
authors.initials: I
authors.lastname: Odibo
authors.affiliation: a Department of Obstetrics and Gynecolog and.
authors.forename: Ashita
authors.initials: A
authors.lastname: Gehlot
authors.affiliation: b Department of Biostatistics , University of Arkansas for the Medical Sciences , Little Rock , AR , USA.
authors.forename: Songthip T
authors.initials: ST
authors.lastname: Ounpraseuth
authors.affiliation: a Department of Obstetrics and Gynecolog and.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
mesh_terms: D005260:Female; D006176:Gynecology / Q000706:statistics & numerical data*; D006801:Humans; D009774:Obstetrics / Q000706:statistics & numerical data*; D010920:Placenta / Q000473:pathology*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011795:Surveys and Questionnaires
keywords: CAP guidelines; obstetrics and gynecology; pathologic examination; placenta