Perinatal Pathology Course

 

History of the Perinatal Pathology Course

The Perinatal Pathology Course evolved from the Perinatal Section of SPP which started in 1999, initially as an ad hoc section.  During the course of these meetings, Dr. Ona Faye-Petersen pitched the idea for a perinatal pathology course to the group circa 2003/4. The goal of the course was to improve the practice of perinatal pathology with a multidisciplinary approach which included the interface between clinical perinatal medicine and pathology. The first Perinatal Pathology Course occurred in May 2005 in Boston.

The course objectives were documented as follows:

     By participating in this course the attendee will

  1. Acquire a good foundation in the clinical aspects of obstetrical and newborn care that have importance in the performance and interpretation of clinicopathologically sound placental and perinatal pathologic examinations.
  2. Understand the indications for complete pathologic examination of the placenta and how to appropriately perform the gross and microscopic placental evaluation.
  3. Be able to recognize normal versus pathologic cord, parenchymal and decidual features and to understand the implications of a set of pathologic findings for the index gestation as well as risks for subsequent pregnancies.
  4. Acquire a basic understanding of how to assess the normalcy and stage of fetal development grossly and histologically, and how to perform an adequate fetal/neonatal autopsy examination, including how to assess the period of intrauterine retention in cases of intrauterine fetal demise.
  5. Acquire an ability to recognize and pathologically evaluate common fetal syndromes and fetal/neonatal cardiovascular, genitourinary and central nervous system malformations, and when and how to use special diagnostic studies to aid in defining the type and cause of an observed malformation/anomalous complex.
  6. Understand how to use reference dissection protocols, formats for reporting, and perinatal morphometric tables as resources in order to be able to generate complete and accurate, but succinct reports for placental and fetal/neonatal examinations.
  7. Learn the placental pathologic features associated with risks of cerebral palsy and neurologic impairment.

 The Perinatal Pathology Course was the first free standing course outside of the regular Spring and Fall SPP meetings.  After planning the first course, the ongoing plan was to have course every ~5 years. The course content has always been approved by SPP committees (education, CME, executive, and council/BOD), and there has always been a course director and management team.  

Interview with Course Director - Dr. Ona Faye-Petersen

 I, Dr. Linda Ernst, talked with Dr. Ona Faye-Petersen on 12/21/2021 and asked her few questions about her experience as the past Director of the SPP Perinatal Pathology Course. The following is a summary of our discussion.

Dr. Ernst: What is your best memory from the perinatal courses over the years?
 
Dr. Faye-Petersen: The first thing that comes to mind is from the 2008 Course in Salt Lake City and the banquet lecture given by the legendary Dr. John Opitz. He was so kind to agree to speak and so modest.  I’ll never forget his phenomenal talk- "Meckel and the Origin of Developmental Pathology".  We were all so fortunate!
 
The second thing that comes to mind is the generosity of Dr. Alex Haezell, maternal fetal medicine specialist from Manchester, in the U.K. I recall sitting near him at a dinner at an international meeting in Europe, where he had just given some great presentations. Earlier that day he had asked me about how he might go about setting up placental pathologic correlative studies for some of his observations and hypotheses. So, at the dinner, I asked him if he would be interested in participating in the SPP Perinatal Pathology Course in 2015. Dr. Haezell was, and still is, a very busy clinician, a brilliant researcher and a highly sought after international speaker. Despite his demanding schedule, he was very supportive of the multidisciplinary structure of the Course and agreed to give some lectures. I told him we would endeavor to pay for at least part of his travel and his response was, “I’ll take care of it. It would be an honor and a privilege for me.” His graciousness, flexibility and support, throughout, left lasting memories.  Although I have not seen him in many years, he remains one of my heroes.
 
Dr. Ernst:  What do you think is the best part of organizing the Perinatal Course?
 
Dr. Faye-Petersen:  First, being able to have the SPP sponsor it as a free-standing Course and being able to recruit national and international experts in perinatal medicine to be part of it. All those approached were so enthusiastic about participating. It made my job easy.
 
Second, after each course, many participants and others who had not been able to attend wanted to know when the next Course was going to be offered. This said to me that the participants found it valuable and had communicated that to their colleagues!
 
Third, one of the strengths of the Course has been its multidisciplinary approach which helps participants develop an understanding of what is useful to know about perinatal clinical medicine. Perinatal medicine really translates into care and management of a two-patient unit, and often includes the postnatal and postpartum periods. The Course’s multifaceted content has benefits over the typical long and short pathology courses, which focus on diagnoses in placental pathology or fetal autopsy pathology, only. It is like a several day expansion of our meeting symposia, since these address specific clinicopathologic entities. Perinatal pathology is a huge field. It involves integration of the maternal medical and obstetrical history, any gestational or delivery complications, and a basic understanding of embryofetal and placental development and function. Challenging areas include detection and understanding of syndromic and non-syndromic fetal anomalies, etiologies of pregnancy loss and the burgeoning field of genetics.   There is so much to the exciting and fascinating story of perinatal pathology and I enjoy helping people understand the field by telling the story.
 
Dr. Ernst:  What advice do you have for folks interested in improving their skills in perinatal pathology?
 
Dr. Faye-Petersen: Obviously - take the Course!
 
But all kidding aside, the first thing is not to compare the process of improving competency in perinatal pathology to their experiences in learning adult pathology. As I’ve indicated, perinatal pathology is more of a “total body process experience” rather than being as organ-specific or disease-specific as adult pathology. Adult pathology deals with mature patients with evolving diseases whereas perinatal pathology deals with disorders affecting the maternofetal placental triad on a moving timeline. It may feel like steep learning curve at first, because it’s less familiar, but if one concentrates on learning the basics of placental structure and norms for growth and histologic maturation and the same for normal fetal development, the rest will fall into place because one will have a scaffolding on which to build. The Course enables pathologists to expand their knowledge base and recognize most pathologic conditions, but reading, viewing internet presentations and maximizing one’s personal experiences by directly learning from perinatal pathologists will help.  It’s important to remember that all the “experts” started as beginners and that they are interested in helping you!  
 
Second, try to accept that there has been and will continue to be an expansive rise in research in perinatal pathology, especially with regards to the placenta.  No one will be able to learn it all, so, if you really want to do perinatal pathology, find an aspect to invest in- something that fascinates you and pursue learning about it by reading, finding examples to study, and asking lots of questions. Join the Perinatal Section in the SPP so you have resource colleagues for consultations and a shared interest in education. My advice is to stay curious - this will help you thrive and keep your interest in the field, and to become a valuable colleague to others.
 
Lastly, strive to make connections with your clinical colleagues and attend their conferences as much as possible. This will increase your visibility as part of the patient care team and also make you a better pathologist!
 
Dr. Ernst:  What are your thoughts for the future of the Perinatal Course?
 
Dr. Faye-Petersen: I would like to see the Course retain at least some of its multidisciplinary content so pathologists can understand and better appreciate clinical evaluation and treatment methods and the challenges facing our perinatal medicine colleagues.  Care of the pregnant woman, fetal assessment of development and well-being, and diagnosis of genetic disorders and placental and fetal abnormalities are just some of the areas that continue to advance. I would like to see pathologists asking clinicians --- how can our examinations and reports be most helpful to you? In my experience, clinicians want to learn from us, and we certainly can, from them.
 
This said, the Course has a finite time limit, so the Director and the Course planning group will need to be choosy when selecting topics! I think it is critical that the Course evolve to reflect what SPP members want most, to ensure the most relevant topics and updates are offered in the time available. Ideally, the Course should strive to provide the most information possible, based on the needs of the participants. The way perinatal research is going, no one will be able to keep up with it all, so I believe the content of the Course needs to remain flexible, and provide information to those with interest in becoming experts as well as those interested in honing their diagnostic skills in placental and fetal pathology. It’s my hope that the Perinatal Course will continue to be an asset to its participants and the SPP by providing information that enhances pathologists’ abilities to offer explanations for cases of adverse perinatal outcomes and to fulfill the SPP’s aim to contribute to improved maternofetal and infant outcomes.  
 
Dr. Ernst: Thank you, Ona, for your passion and dedication to our field. I hope the Perinatal Pathology Course will be an enduring part of the SPP for many years to come, and you should be very proud of all the work you have put into it to make it accessible and enjoyable to all of us.
 
Dr. Faye-Petersen: Thank you Linda. It’s been my distinct pleasure to see this Course get established and to be part of so many of its offerings.  I especially thank you for inviting me to participate in the most recent one in April 2021.  You did an outstanding job. It was so great to see you carry it forward with such excellence.
 

Past Courses

The live 2021 Perinatal Pathology Course, held virtually, was accredited for CME. Please reach out to [email protected] if you need to claim credit. The recorded content made available to registered attendees is no longer available and was not accredited for CME. 

Click here to view the 2021 Perinatal Pathology Course Program Book

To date, there have now been 4 Perinatal Pathology Courses:

First course – 2005 Boston – (initially picked for good location and proximity to many experts in perinatal pathology).

  • Director: Dr Ona Faye-Petersen
  • Manager (USCAP): Jim Crimmins and Carolyn Lane
  • Dates: Friday May 20- Sunday May 22, 2005
  • Hotel: Omni Parker Hotel, Boston, MA
  • Participants: ~80

Second course – 2008 Salt Lake City

  • Director: Dr Ona Faye-Petersen
  • Manager: Kerry Crockett and Carolyn Lane
  • Dates: Friday, May 2- Sunday, May 4, 2008   
  • Hotel: University Park Marriott, 480 Wakara Way, Salt Lake City, Utah
  • Participants: ~100

Third course – 2015 Chicago

  • Director: Dr Ona Faye-Petersen
  • Manager: Kerry Crockett and Carolyn Lane
  • Dates: Friday, April 17 - Sunday, April 19, 2015                   
  • Hotel: Embassy Suites Downtown/Lakefront, 511 N. Columbus Drive, Chicago, IL  60611  
  • Participants:  ~150

Fourth course – 2021 Virtual

  •  Director: Dr Linda Ernst
  • Manager: Jordan Burghardt
  • Dates: Thursday April 8 – April 11, 2021
  • Virtual format
  • Participants: 227 (55 “Junior”/“Junior/Resident”, 111 member, 61 non-member)   

Perinatal Pathology Course Agendas

BOSTON 2005

Friday May 20, 2005

Welcome and Introduction
Dr. Ona Faye-Petersen
What The Pathologist Needs To Know About Obstetrics Part I
Dr. Sabrina Craigo
What The Pathologist Needs To Know About Obstetrics Part II:
Dr. Sabrina Craigo
Neonatology For The Pathologist: Part I What You Need To Know About The NICU In The 21st Century
Dr. Elaine St. John
Neonatology For The Pathologist: Part II: What The Neonatologist Wants To Know From The Pathologist: 
Dr. Elaine St. John
Course Dinner and Presentation
“What the Obstetrician Needs to Know From the Pathologist”
Sabrina Craigo, MD; Director, Division of Maternal-Fetal Medicine, New England Medical Center; Department of Obstetrics/Gynecology, Division of Maternal-Fetal Medicine
 

Saturday May 21, 2005

Placental Gross Examination Part I:
Dr. Cynthia Kaplan
Placental Gross Examination Part II:
Dr. Cynthia Kaplan
Placental Microscopic Examination Part I: Overview & Pathology of Ascending Infections 
Dr. Raymond Redline
Placental Microscopic Examination: Part II: Villitis: 
Dr. Raymond Redline
Placental Microscopic Examination: Part III: Pathology of Placental Bed Underperfusion And Chronic Chorionic Villous Hypoxia
Dr. Rebecca Baergen
Placental Microscopic Examination: Part IV: Other Important Pathologic Lesions
Dr. Rebecca Baergen
Features of Normal Fetal Development And of Retention Following Intrauterine Fetal Demise 
Dr.  Drucilla Roberts
External Examination of the Fetus/ Neonate & Guidelines For Postmortem Photodocumentation And Special Studies  
Dr. Drucilla Roberts 
 
Sunday, May 22, 2005
 
The Perinatal Autopsy Part 1
Dr. Halit Pinar
The Perinatal Autopsy Part II
Dr. Halit Pinar
Features of Common Malformations, Associations And Syndromes (Previable Abortus And Third Trimester Gestational Age Fetus/ Newborn)
Dr. Ona Faye-Petersen
Gross and Microscopic Examination of Fetal/Neonatal Central Nervous System
Dr. Rebecca Folkerth
Placental Pathology Associated with Risks Of Cerebral Palsy and Neurologic Impairment
Dr. Raymond Redline
Fundamental Features of The Most Frequently Encountered Congenital Cardiovascular Malformations
Dr. Ona Faye-Petersen
 

SALT LAKE CITY 2008

Friday May 2, 2008

“Prenatal Ultrasonography”
Janice L.B. Byrne, MD
“Multiple Gestations and Complications”
Janice L.B. Byrne, MD
“Update on Causes of Preterm Labor”
by M. Sean Esplin, MD; presented by Robert M. Silver, MD
“Causes of Stillbirth”
Robert M. Silver, MD
"‘Bad placentas’ - Preeclampsia, Fetal Growth Restriction, Antiphospholipid Syndrome, and Thrombophilias”
D. Ware Branch, MD
“Gross Examination of Singleton Placenta, Part 1”  
 Cynthia G.  Kaplan, MD
“Gross Examination of Singleton Placenta, Part 2”  
Cynthia G.  Kaplan, MD
“Normal Development of Facial Structures: an Approach to Facial Clefts”
 Luc L. Oligny, MD
Course Dinner and Presentation: "Meckel and the Origin of Developmental Pathology"
John M. Opitz, M.D., M.D.h.c., D. Sci.h.c., M.D.h.c., FAAP, DABMG, FACMG
Professor of Pediatrics, Human Genetics, Obstetrics & Gynecology, and Pathology, University of Utah Health Sciences Center

Saturday, May 3, 2008
 
“Gross Examination of Twin and Multiple Gestation Placentas, including study of Fetoplacental Cases of Twin-to-Twin Transfusion Syndrome (TTTS) & Twin Reversed Arterial Perfusion  (TRAP) Syndrome”
Cynthia G. Kaplan, MD
“Placental Microscopic Examination, Part 1:  Overview of Normal Histology & Pathology of Ascending Infections”
Raymond W. Redline, MD
“Placental Microscopic Examination Part 2: Villitis”
Raymond W. Redline, MD
“Placental Microscopic Examination, Part 3: ‘Miscellaneous’ but Important Pathologic Lesions”
Rebecca N. Baergen, MD
“Fetal and Placental Features of Intrauterine Retention Following Fetal Demise and Distinguishing Placental Retention Features From Antemortem Pathology”
Ona Faye-Petersen, MD
“Placental Microscopic Examination Part 4:  Pathology of Placental Bed Underperfusion and Chronic Chorionic Villous Hypoxia” 
Rebecca N. Baergen, MD
“Highlights of Normal Fetal Development and Features of Common Malformations and Syndromes”
Ona Faye-Petersen MD
“Normal Lung Development and an Update in Pulmonary Malformations”
Laura S. Finn, MD
 
Sunday, May 4, 2008
 
“Normal Kidney Development and Update in Cystic Renal Diseases”   
Laura S, Finn, MD
“The Perinatal Autopsy, Purpose and Protocol, Part 1”
Luc L. Oligny, MD
“The Perinatal Autopsy, Purpose and Protocol, Part 2”
Luc L. Oligny, MD
“Placental Lesions Associated with Risks of Neurologic Impairment in the Infant”
Raymond W. Redline, MD
“An Approach to Non-immune Fetal Hydrops”
Luc L. Oligny, MD
“Fundamental Features of the Most Frequently Encountered Congenital Cardiovascular Malformations”
Ona Faye-Petersen, MD
 
CHICAGO 2015

Friday April 17, 2015
 
“Update on Prenatal Ultrasonography and Detection of Fetal Anomalies”
Alexander Heazell, MBChB (Hons), PhD, MRCOG
“Clinical Assessment of Fetal Growth and Well-being, and Implications of Abnormalities of Fetoplacental Blood Flow”
Emily J. Su, MD, MSCI
“Update in Prenatal Maternal Serologic, Amniotic Fluid, and Chorionic Villi Testing and the Role of Molecular Genetics in Viable and NonViable Pregnancies” 
Jeffrey S. Dungan, MD
“Update on the Pathogenesis of Bronchopulmonary Dysplasia and Other Complications of Prematurity”
Karen K. Mestan, MS, MD
“What the Neonatologist Wants to Know From the Placental Examination and Neonatal Autopsy”
Karen K. Mestan, MS, MD  
“Gross Examination of the Singleton Placenta”
Robert W. Bendon, MD                     
“Normal Placental Morphologic and Functional Development”  
Ona M. Faye-Petersen, MD
“Placental Gross and Microscopic Examination Part 1: Pathology of Placental Bed Under Perfusion and Placental Abruption/ Retroplacental Hematoma”   
Robert W. Bendon, MD
Course Dinner and Presentation: “What Does the Obstetrician Want to Know From the Pathologist?”
Alexander Heazell, MBChB (Hons), PhD, MRCOG
                            
Saturday, April 18, 2015
 
“Placental Gross and Microscopic Examination Part 2:  Fetal Stromal- Vascular Lesions, Distal Villous Immaturity/Maturational Defects, Villous Capillary Lesions, and Dysmorphic Villi”
Raymond W. Redline, MD
“Placental Gross and Microscopic Examination Part 3: Ascending Intrauterine Infections”
Jason A. Jarzembowski, MD, PhD
“Placental Gross and Microscopic Examination Part 4: Infectious Villitis”
Jason A. Jarzembowski, MD, PhD
“Placental Gross and Microscopic Examination Part 5: ‘Miscellaneous’ but Important Pathologic Lesions”
Linda M. Ernst, MD, MHS
“Placental Pathology with Medicolegal Imperative and Adverse Infant Outcomes”
Raymond W. Redline, MD
“Highlights of Normal Fetal Development and Features of Common Malformations and Syndromes”
Ona M. Faye-Petersen, MD
“An Overview of Fetal Cardiac Physiology and Function”
Nina L. Gotteiner, MD
“Prenatal Ultrasonographic Features of Fetal Cardiovascular Malformations and Anatomic Pathologic Correlations”
Nina L. Gotteiner, MD and Michael K.  Fritsch, MD, PhD
 
Sunday, April 19, 2015
 
“The Perinatal Autopsy Examination Part 1”
Eileen M. McKay, MD
“The Perinatal Autopsy Examination Part 2
Eileen M. McKay, MD
“Normal Developmental Histology of the Fetal Kidney, Lung, Liver, and Gonads”
Linda M. Ernst, MD, MHS
“Use of Postmortem Radiographs in Perinatal Pathology”
Ona M. Faye-Petersen, MD
“Hydrops Fetalis: Pathologic Mechanisms and Differential Diagnosis”
Ona M. Faye-Petersen, MD
 
VIRTUAL 2021

Thursday, April 8, 2021 –PERINATAL AUTOPSY
 
Approach to Perinatal Autopsy 
Michael K. Fritsch M.D., PhD & Linda Ernst, M.D., M.H.S.
Normal Fetal Histology
Linda Ernst, M.D., M.H.S.
Pathology of Stillbirth/Intrauterine Stress
Michael K. Fritsch M.D., PhD
Evaluation of the Hydropic Fetus/Infant 
Ona Faye-Petersen, M.D.
Skeletal Evaluation & Skeletal Dysplasia
Linda Ernst, M.D., M.H.S.
 
Friday April 9, 2021
Evaluation of Congenital Heart Disease
Chrystalle Katte Carreon, M.D.
Perinatal Neuropathology
John M. Lee, M.D., PhD
Normal Placental Development & Function
Ona Faye-Petersen, M.D.
Gross Placental Pathology
Rebecca Baergen, M.D.
Lecture, Don Singer, M.D., – A Historical View of Perinatal Pathology

Saturday, April 10, 2021
 
Maternal Vascular Pathology
Raymond W. Redline, M.D.
Fetal Vascular Lesions
Sanjita Ravishankar, M.D.
Miscellaneous Placental Lesions
Linda Ernst, M.D., M.H.S.
Acute and Chronic Placental Infections
Jason Jarzembowski, M.D., PhD
Case Presentations/Panel Discussion: Controversies in Placenta Pathology & Medical Legal Issues
Ona Faye-Petersen, M.D., Rebecca Baergen, M.D., Raymond W. Redline, M.D. 
Alexis Carena, National Accreta Foundation guest speaker
 
Sunday, April 11, 2021
 
Evaluation of the Twin Placenta
Monique DePaepe, M.D.
Accreta Spectrum Disorders 
Jonathan Hecht, M.D., PhD
Molar Pregnancy 
Debra Heller, M.D.
“Informal” cases and Conversations
Terry Morgan MD, Amy Hereema MD, Linda Ernst MD