39 (2015) 1

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Introduction In preparing to guest edit this issue of Seminars in Perinatology, I began to reflect on how surprisingly broad the field of perinatal pathology is. Our pathology colleagues (those not in perinatal pathology) tend to see our field as almost static, a calm quiet pool in the otherwise cascading river of new diagnoses and new tests that characterize contemporary pathology. This misperception likely arises from the unusual nature of our workload. The bulk of perinatal pathology cases are placentas, perceived by many pathologists as simultaneously boring and perplexing, which appear to inspire few outside of our small core group of perinatal pathologists. And if we are not examining placentas, then we have disappeared into the morgue to perform autopsies. While we find this procedure fascinating, our pathology colleagues will likely never hear about the many newly defined genetic disorders that cross our table. In fact, our field is as vast and rapidly changing as any field in pathology. In developing this issue, the biggest problem I encountered was in deciding which areas I would have to exclude. The reviews in this issue all either engage controversies in fields within perinatal pathology or discuss new findings in the most quickly moving fields. The issue commences with a review that slices deeply into one of the most vexing problems in placental pathology. Placental pathology is unfortunately one of the least welltaught fields in pathology residencies, and the result is a large number of practicing pathologists only vaguely familiar with this organ. The first review responds to this problem by concisely providing guidelines for the clinical utility of placental examination. The next two reviews, one covering what has classically been considered hypoxic damage to the placenta, and the other covering chronic inflammatory lesions in the placenta, both address areas that are actively evolving, while still retaining topics of sometimes heated controversy. Fetal therapy for monozygotic twin pregnancies is another rapidly developing field, and the fourth review explores the technically involved examination of these important yet complicated placentas. At this point, the issue moves from the placenta to the fetus or neonate. This section

W. Tony Parks begins with a review discussing the pathology and etiology of perinatal central nervous system anomalies. There has been a recent explosion of research identifying underlying molecular mechanisms for numerous developmental brain abnormalities. This review masterfully details how one signaling pathway has been implicated in a range of brain aberrations. The field of perinatal cytogenetic analysis has shown even more rapid advances. Classical karyotype analysis has nearly been swept away by the newer microarray and sequencing technologies outlined in the sixth review. The seventh review details the techniques for and clinical utility of the perinatal autopsy, aiming to demystify for our clinical colleagues this valuable but incompletely understood procedure. The issue ends with a topic underrepresented in the pathology literature (outside of the forensic literature), pathologic identification of iatrogenic injury in the perinatal period.

W. Tony Parks Department of Pathology, Magee-Womens Hospital of UPMC 300 Halket St, Room 4436, Pittsburgh, PA 15213 E-mail address: [email protected] http://dx.doi.org/10.1053/j.semperi.2014.10.001 0146-0005/& 2014 Elsevier Inc. All rights reserved.

Introduction. Perinatal pathology.

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