Collect the tissue using a metal strainer, filter paper in a funnel, or a fine mesh tissue processing bag.
Measure (3 dimensions, in aggregate). Large specimens should be weighed. Describe the fragments (color, friability, shape – irregular vs. cylindrical cores vs. globular). State the proportion of blood clots relative to the entire specimen. If the specimen is tissue spontaneously passed, mention whether the tissue appears to be a decidual cast.
In cases of suspected abortion, search for chorionic villi, if necessary under a dissecting microscope. Examine for presence of gestational sac and embryonic/fetal tissue. Examine the embryonic/fetal tissue for malformations and maceration. Measure the crown-rump length and foot length, or measure whatever parts are present. If the fetus is large enough to perform an internal examination, consult the pediatric pathologist.
In cases of recurrent abortion, send a sample of villi for possible cytogenetic evaluation, if requested. Clean the forceps, other instruments, and table carefully before and after handling the tissue.
In cases of molar pregnancy, the villi may be cystically dilated (“grape-like”).
For endometrial biopsy: Submit all tissue in a tissue processing bag. Do not fill the cassettes more than half full. Request three levels on each block.
For endometrial curettage for incomplete abortion or spontaneously passed tissue: Submit three representative sections of tissue with the appearance of placenta, fetal parts, gestational sac, and decidua unless the entire specimen is small enough to fit into three cassettes. Avoid submitting blood clot. If the microscopic sections do not show products of conception, submit the rest of the material.
For molar pregnancies: Submit ten blocks or the entire specimen (whichever is less).
Received without fixative/in formalin, labeled _____ and “_____”, are five friable, red-brown, cylindrical soft tissue cores measuring __ x __ x __ cm in aggregate. Entirely submitted in cassette #__ .
__ blocks, __ H&E
Products of Conception
Received without fixative/in formalin in a suction container, labeled _____ and “_____”, are numerous irregular, red-brown to gray-tan, friable fragments of soft tissue and blood clot, in aggregate __ x __ x __ cm. Clots comprise approximately __% of the specimen. A few fragments of soft tissue appear globular. There is also a ruptured/unruptured translucent gray gestational sac measuring __ cm in diameter and a separate/containing a normally-formed/malformed macerated/unmacerated embryo with a crown-rump length of __ cm and a foot length of __ cm. Representatively submitted as follows: