Obstetric and Perinatal Pathology

Obstetric and Perinatal Pathology

The perinatal pathology group provides diagnostic services to patients of Massachusetts General Hospital. There is a large volume of in-patient material of high quality due to the busy obstetric, maternal-fetal medicine reproductive endocrine, neonatology and general obstetric services of the Mass General. This is reinforced by outstanding case material seen from other institutions and has provided a rich reservoir of material for numerous academic contributions over the years.

Our perinatal pathologist is Dr. Drucilla J. Roberts, Subspecialty Head. The material supervised by these attending pathologists includes the subset of pathology of females represented by specimens of placentas, products of conception, gravid hysterectomies, ectopic pregnancies, fetal, neonatal, and maternal  autopsies. Additionally the service is responsible for several conferences: weekly obstetric QA conference, obstetrical outs and perinatal conference.

The first-year residents are oriented to the service by Dr. Roberts during the summer months by daily one-on-one teaching at the gross bench. In addition to routine grossing of specimens the residents learn how to triage placental specimens to pathologic examination vs. storage, float chorionic villi for identification, interpret fetal radiographs and chromosomal analyses, and obtain tissues for special studies (e.g., viral cultures, metabolic evaluation). Second year and more senior residents have rotations in the obstetric service as electives.

Faculty

• Drucilla J. Roberts, MD - Subspecialty Head, Obstetric and Perinatal Pathology
• Vanda F. Torous, MD
• Katelyn Dannheim, MD

Clinical Program

The in-house material provides a broad range of outstanding case material for resident teaching. As noted above, this is reinforced by material from referral cases, the latter providing much of the resources for the research activities outlined below. The attending pathologists provide consultative services as needed in the frozen section laboratory and present at weekly multidisciplinary perinatal and a genetics/OB ultrasound. Several members also provided cytopathology services.

Academic and Research Accomplishments

Every year, many contributions in peer review journals are published, both in conventional clinico-pathologic,  and translational and basic research areas. These include collaborations with pathologists from other institutions and Mass General clinicians and basic researchers. Dr. Roberts is pathologist for many research programs involving perinatal and pediatric pathology including:

• PASS – Prenatal alcohol and SIDS and stillbirth. International multicenter study to look at effects of prenatal alcohol exposure. Placental and autopsy study. Based at Boston Children's Hospital
• PRESS – Pediatric respiratory etiology surveillance study – autopsy with extensive microbiologic investigations to understand the etiology of pediatric respiratory deaths. Based in Nairobi, Kenya. Study with CDC and KEMRI
• Malaria – Effects of small molecules and iron supplementation on the prevalence and severity of placental malaria. Based in Dar es Salaam, Tanzania. Placental pathology
• Placental correlates of MRI and Neurologic diagnoses – based at Mass General
• Placental pathology of glucose intolerance – based at Mass General
• Placental pathology associated with HAART therapy, HIV, and stillbirth – based in Botswana
• Consults on other animal model studies involving placental pathology including:
  • SERT – Effects of serotonin on placental and embryonic pathology. Murine and human studies.
  • PET – Murine model of pre-eclampsia. Different studies  involving placental pathology. Based at BIDMC

Visit our Pathology Global Health Program pages for more information about training opportunities.

The obstetric and perinatal service holds an annual postgraduate course on gynecologic and obstetric pathology and, under the direction of Dr. Roberts, there is additionally a hands-on tutorial in obstetric pathology.