Best practice guidelines for standardised placental pathology reporting: A recommendation by perinatal pathology working group, Chapter of Perinatal and Paediatric Pathology, College of Pathologists, Malaysia.

Placental pathology provides critical diagnostic, prognostic and clinicopathological insights into maternal-foetal outcomes. While frequently discarded post-delivery, macroscopic and histopathological evaluation can clarify adverse outcomes, including stillbirth, neonatal death, prematurity, foetal growth restriction, hydrops, infection and complicated multiple gestations. This paper outlines a standardized framework for placental examination by covering rationale, indications, specimen handling, sampling and reporting designed for universal implementation across all public, private and academic healthcare facilities. To optimise institutional resources, a phased, indication-based approach is recommended initially, prioritising cases most likely to influence clinical management, parental counselling and future pregnancy care. Pre-analytical optimisation, which includes proper specimen handling, adequate fixation, representative sampling and complete clinical history, is essential to maximize diagnostic yield nationwide. We propose a structured reporting proforma aligned with the current Amsterdam Consensus Classification, including a dedicated section for multiple gestations. This standardises reporting across key pathophysiological domains: maternal vascular malperfusion (MVM), foetal vascular malperfusion (FVM), infections, inflammatory/immune lesions and villous developmental abnormalities. Finally, contextual ancillary investigations are discussed. Ultimately, establishing a unified, cross-sector national placental pathology service holds the potential to significantly improve the audit of adverse perinatal outcomes and elevate maternal-foetal care.