Department of Pathology, Massachusetts General Hospital, Boston, MA 02115, USA.
Arch Pathol Lab Med. 2013 Jun;137(6):775-81. doi: 10.5858/arpa.2011-0560-SA.
The practice of perinatal pathology in much of the world suffers, as do all subspecialties of anatomic pathology, from inadequate resources (equipment, consumables, and both professional and technical personnel), from lack of education (not only of the pathologist but also of the clinicians responsible for sending the specimens, and the technicians processing the specimens), and from lack of appropriate government sector support. Perinatal pathology has significant public health-related utility and should be championing its service by providing maternal and fetal/infant mortality and morbidity data to governmental health ministries. It is with this pathologic data that informed decisions can be made on health-related courses of action and allocation of resources. These perinatal pathology data are needed to develop appropriate public health initiatives, specifically toward achieving the Millennium Developmental Goals as the best way to effectively decrease infant and maternal deaths and to determine causes of perinatal mortality and morbidity. The following overview will focus on the utility of perinatal pathology specifically as related to its public health function and will suggest methods to improve its service in resource-poor settings. This article is offered not as a critique of the current practice that most pathologists find themselves working in globally, but to provide suggestions for improving perinatal pathology services, which could be implemented with the limited available resources and manpower most pathology departments currently have. In addition, we offer suggestions for graded improvements ("ramping up") over time.
世界上许多地方的围产病理学实践都存在不足，正如解剖病理学的所有亚专科一样，存在资源（设备、耗材以及专业和技术人员）不足、教育不足（不仅是病理学家，还有负责发送标本的临床医生以及处理标本的技术人员）以及缺乏政府部门支持的问题。围产病理学具有重要的与公共卫生相关的效用，应该通过向政府卫生部门提供孕产妇和胎儿/婴儿死亡率和发病率数据来倡导其服务。正是有了这些病理数据，才能就与健康相关的行动方案和资源分配做出明智的决策。需要这些围产病理学数据来制定适当的公共卫生计划，特别是为了实现千年发展目标，这是有效降低婴儿和产妇死亡率的最佳途径，并确定围产死亡率和发病率的原因。以下概述将重点关注围产病理学的效用，特别是其与公共卫生功能的关系，并提出在资源匮乏环境中改善其服务的方法。本文不是对大多数病理学家在全球范围内发现自己所处的当前实践的批评，而是提供改善围产病理学服务的建议，这些建议可以在大多数病理科目前拥有的有限资源和人力的基础上实施。此外，我们还提出了随着时间的推移逐步改进（“逐步提升”）的建议。
