Pathology, Products of Conception (POC)

Fetal Death

Specimen Type: Fetus

Collection Instructions:

1. A fetus is treated as a fetal death if the fetus is ≥20 weeks gestational age. Fetal weight of 500 grams or fetal crown to heel length of 25 cm is considered equivalent of 20 weeks gestational age.

2. Fetus should be sent directly to the Sarasota Memorial Hospital Morgue upon determination of fetal death.

Note:  Morgue staff will obtain necessary permits if an autopsy is requested, and will handle release of the body to a funeral home.

Fetal Death (Cytogenetic Testing)

Specimen Type: Fetus

Collection Instructions:

1. To ensure optimum specimen viability, cytogenetic testing should be ordered and a specimen obtained prior to delivery of body to SMH Morgue. Follow instructions for cytogenetic testing on tissue.

2. If body has already been delivered to Sarasota Memorial Hospital Morgue prior to a request for cytogenetic testing, call SaraPath Diagnostics at 941-362-8900, Monday through Friday, 8 a.m. to 5 p.m.; or call Sarasota Memorial Laboratory Services at 941-917-1350 or 866-747-0395 on evenings, weekends, or holidays for assistance.

3. Label specimen with at least 2 sources of patient identification (eg, bar code, patient name, or other unique identifier), date of collection, and type and site of specimen.

Note:  

1. Complete a SaraPath Diagnostics requisition, include all relevant clinical information, and submit with specimen.

2. If cytogenetic testing is requested, list cytogenetic specimen and permanent tissue specimen separately on pathology requisition. Include as much clinical information on requisition as possible (ie, history of spontaneous abortion, family genetic history, abnormal ultrasound).

3. If family requests an autopsy or burial, these instructions should be included on pathology requisition.

4. Verify that identifiers on requisition match those on specimen.

Tissue

Specimen Type: Fetal tissue

Collection Instructions:

1. A fetus is treated as a tissue specimen if fetus is <20 weeks gestational age and no autopsy is requested. Fetal weight of 500 grams or fetal crown to heel length of 25 cm is considered the equivalent of 20 weeks gestational age.

2. The family may request that a tissue specimen be sent to Sarasota Memorial Hospital Morgue for release to a funeral home.
3. An autopsy may be requested per autopsy permit protocol on fetal tissue that is <20 weeks gestational age. The person signing the autopsy permit should specify how tissue will be handled after autopsy (ie, as a tissue specimen with disposition by pathology, as a burial, or cremation by funeral home.

Note:

1. Morgue staff will obtain necessary permits if an autopsy is requested, and will handle release of body to a funeral home.

2. Tissue is retained in pathology for 2 weeks prior to disposal. Requests by family must be received by pathology within the 2 week specimen retrieval period.

Tissue (Cytogenetic Testing)

Specimen must arrive within 24 hours of collection.

Specimen Type: Fetal tissue

Sources: Biopsy, placenta (tissue that contains chorionic villi), tissue where umbilical cord joins placenta, skin punch biopsy from under arm or inner thigh, internal organs (ie, liver, lung, kidney, or thymus).

Collection Instructions:

1. Call Sarasota Memorial Laboratory Services at 941-917-1350 or 866-747-0395 to obtain appropriate transport media.

2. Transport media is preferred, sterile saline is acceptable.

3. Do not submit entire fetus.

4. Tissue where umbilical cord joins placenta is best.

5. Avoid muscle, tendons, or tough skin (such as heel) for punch biopsies. Biopsy should be the size of a dime to a quarter.

6. Obtain 3 to 4 mm of POC or 50 to 100 mg of each tissue. If possible, always include chorionic villi.

7. Specimen should be separated into 2 parts by surgeon using sterile technique.

a. Snip tissue using sterile scissors.

b. Cover specimen with sterile gauze to prevent contamination from airborne bacteria, or saline and refrigerate immediately. Specimen will not survive longer than 24 hours unless refrigerated.

c. Immediately place tissue for cytogenetic testing in transport media.

d. Remaining tissue should be placed into 10% formalin for routine pathology examination.

e. If separation of tissue is not possible, submit entire specimen in saline.

Note:

1. Cytogenetic and tissue specimens should be delivered to SaraPath Diagnostics Monday through Friday from 8 a.m. to 5 p.m. On evenings, weekends, and holidays specimen should be delivered to a laboratory supervisor in main laboratory at Sarasota Memorial Laboratory Services.

2. Specimen collected on holidays, Saturday after 1 p.m., or Sunday will be sent for cytogenetic studies the next business day.

3. SaraPath Diagnostics will pick-up specimens delivered to the laboratory supervisor at Sarasota Memorial Laboratory Services, and after processing will deliver specimen to Sarasota Memorial Laboratory Services Send-Out Department for send-out the next business day.

4. If properly collected and promptly refrigerated, specimen can be sent for cytogenetic testing on next business day.

Note:

1. Specimen may be rejected and returned to originating site if any of the following conditions apply:

a. Fixed with formalin, formaldehyde, or alcohol (as fixative will kill cells)

b. Frozen (as freezing will destroy cells)

c. Patient or specimen identification errors or omissions

d. Information on specimen and requisition do not match

e. Incorrect specimen submitted for test requested

2. For technical assistance call SaraPath Diagnostics at 941-362-8900 or Sarasota Memorial Laboratory Services at 941-917-1350 or 866-747-0395.

3. For supplies call Sarasota Memorial Laboratory Services at 941-917-1350 or 866-747-0395.