Alturkustani Murad, Alomran Astabraq, Al-Thomali Hind H
Pathology, King Abdulaziz University, Jeddah, SAU.
Cureus. 2024 Aug 5;16(8):e66153. doi: 10.7759/cureus.66153. eCollection 2024 Aug.
Background and objective Standardizing placental pathology diagnoses is crucial for improving diagnostic accuracy and clinical communication. The Amsterdam Consensus Criteria were developed to address inconsistencies in diagnosing significant placental pathologies. This study aimed to assess the application and effectiveness of the Amsterdam Consensus Criteria in diagnosing placental pathologies, with a focus on improving the reliability and precision of placental pathology reports. Methods A retrospective review of 100 consecutively archived placental pathology samples was performed at a tertiary care hospital. These samples, gathered from January through December 2021, were reassessed according to the Amsterdam criteria. The revised diagnoses were then compared with the original descriptive diagnoses. Results Significant changes were noted in all principal diagnoses, including maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), chronic villitis of unknown etiology (VUE), and acute chorioamnionitis (ACA). This evaluation led to a recategorization of several cases. Frequently, parenchymal infarcts were reported without adequate information to ascertain their association with MVM. Additionally, there was a noticeable lack of understanding of FVM and VUE among pathologists. ACA was the condition most consistently documented. However, detailed grading and staging were often not included. Conclusions Our findings emphasize the need to use standardized diagnostic criteria, such as the Amsterdam criteria, to enhance diagnostic accuracy and facilitate communication between pathologists and clinicians. This will ultimately lead to improved patient care outcomes. It also underlines the necessity of continuous education and calibration for pathologists to mitigate interobserver variability. There is a demand to modify these criteria to ensure universal applicability and relevance in various clinical settings.
背景与目的 标准化胎盘病理诊断对于提高诊断准确性和临床沟通至关重要。制定阿姆斯特丹共识标准是为了解决重要胎盘病理诊断中的不一致问题。本研究旨在评估阿姆斯特丹共识标准在胎盘病理诊断中的应用及有效性，重点在于提高胎盘病理报告的可靠性和精确性。方法 在一家三级护理医院对100例连续存档的胎盘病理样本进行回顾性分析。这些样本收集于2021年1月至12月，根据阿姆斯特丹标准重新评估。然后将修订后的诊断结果与原始描述性诊断进行比较。结果 在所有主要诊断中均发现了显著变化，包括母体血管灌注不良（MVM）、胎儿血管灌注不良（FVM）、病因不明的慢性绒毛炎（VUE）和急性绒毛膜羊膜炎（ACA）。这一评估导致了几例病例的重新分类。通常，在报告实质梗死时缺乏足够信息来确定其与MVM的关联。此外，病理学家对FVM和VUE的认识明显不足。ACA是记录最一致的情况。然而，详细的分级和分期往往未包括在内。结论 我们的研究结果强调需要使用标准化诊断标准，如阿姆斯特丹标准，以提高诊断准确性并促进病理学家与临床医生之间的沟通。这最终将改善患者护理结果。它还强调了对病理学家进行持续教育和校准以减少观察者间差异的必要性。需要修改这些标准以确保在各种临床环境中的普遍适用性和相关性。
