By Eleanor Cummins; STAT News
When Mana Parast examines a placenta, she knows she may never find the answers she seeks. She’s hunting for clues — strips of dead tissue that signal autoimmune disease, white blood cells in the lining of the umbilical cord that point to an infection, thickening that could suggest blood wasn’t flowing freely to the fetus.
She wants to be able to tell a parent what she thinks went wrong.
Parast is one of just a few physician-scientists in the U.S. specializing in perinatal pathology, an overlooked and underfunded field tasked with analyzing fetal tissue, placentas, and other so-called products of conception to sleuth out why a mother miscarried — and hopefully, prevent further losses.
After a miscarriage or stillbirth, placentas — the temporary organ that protects and nourishes a fetus for the duration of a pregnancy — can harbor important evidence. While the majority of pregnancy loss is the result of genetic abnormalities, tightly wound umbilical cords, placentas that suddenly stop growing, and evidence of scarring are also clues in the 100 to 120 cases Parast and her team investigate each year. But for all of perinatal pathology’s promise, every case, even the ones considered “solved,” reveals just how little modern medicine knows about pregnancy loss, and how much there is still to learn.
“I don’t think we should underestimate the utility of placenta pathology,” Parast, who serves as director of the perinatal pathology service at University of California, San Diego, said. “Having said that, it’s not a crystal ball.” It’s rare to identify a single cause for a fetal death, especially after the first trimester. And while there are a few causal explanations for pregnancy loss — conditions in which no fetus could ever survive — most are merely correlational.
Continue reading on statnews.com.