Abstract:
A container for examination and storage of a placenta includes a bottom wall, at least one substantially upright side wall joined to the bottom wall to define an interior and an open top. The side walls and/or the bottom wall have indicia thereon adapted to measure the size of the placenta in three dimensions. Indicia are also provided to measure the umbilical cord. The container is stackable for storage, and labeling areas are provided. A basic method of examining a placenta is disclosed, along with further steps and variations.

Description:
BACKGROUND OF THE INVENTION 
     The present invention relates to the field of medical science and the sub-field of obstetrics. More particularly, this invention relates to a container for storing and examining a placenta following the delivery of a baby. The invention provides a gross placenta examination kit (GPEK) and a method for using the same for non-surgical evaluation of the placenta. 
     In general, sterile specimen containers for body tissue and the like are well known. One such container is disclosed by Muheim in U.S. Pat. No. 3,575,225. A pliable or flexible plastic bag attaches to a rigid spatula-like frame with a lid pivotally mounted thereon and has a top opening for insertion of a placenta, other medical items, and even food. A 2000 cc transparent or translucent bag is recommended for collection and disposal of a placenta. The bag has a single set of markings calibrated for measuring the fluid volume of the placenta in a constrained state within the flexible bag. The markings are disposed only on one side wall of the bag. No suggestion is made that the marks should protrude from the surface of the bag. 
     There is a need for a container for examining and storing the placenta in essentially a free state, wherein the placenta is supported on its maternal surface and is in an open, easily visible and accessible condition conducive to examination. There is also a need for a container which can measure free state length, width, and height or thickness of a placenta, as well as the diameter and length of the umbilical cord if present. 
     Therefore, a primary objective of the present invention is the provision of an improved container for gross examination and storage of a placenta. 
     Another objective of this invention is the provision of a method of examining a placenta on a gross basis for various characteristics or abnormalities. 
     Another objective of this invention is the provision of a container which is economical to produce and yet easy, accurate and reliable in use. 
     These and other objectives will become apparent from the drawings, as well as the description and claims which follow. 
     SUMMARY OF THE INVENTION 
     The present invention relates to a method and container for examining and storing placentas. The plastic container has a bottom with one or more upright side walls joined thereto. The bottom receives and supports a placenta which can have a length of umbilical cord attached. The side walls include a multitude of visually discernible marks thereon arranged along at least three different orthogonal axes. The marks are preferably formed as ridges or protrusions on the inside of the respective side walls, although other forms of marking will suffice. 
     A first set of marks includes marks spaced horizontally at known intervals along one of the bottom wall or the side walls so as to measure the length of the placenta, a second set of marks includes marks spaced horizontally along the bottom or one of the other side walls perpendicular to the first set of marks so as to measure the width of the placenta. A third set of marks includes marks spaced apart and extending upwardly at known intervals along one of the side walls so as to measure the height or thickness of the placenta from the bottom wall. The third set of marks extends perpendicular to the first and second set of marks. 
     A fourth set of marks spaced apart at known intervals can also be provided on the bottom wall or one of the side walls so as to measure the diameter of the umbilical cord. 
     The container is constructed so as to be stackable. A lid can be sealingly mounted to the top of the side walls in order to cover the container. The placenta specimen can be placed in the container, then sealed and stacked on a refrigerator shelf for storage. When the desired retention period expires, the placenta specimen can be discarded as biohazard waste, preferably in the same container. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is an exploded perspective view of the container of this invention. 
     FIG. 2 is a perspective view of the container of FIG. 1 with the lid removed and a placenta placed therein for gross examination and storage. 
     FIG. 3 is a sectional view of the container taken along line  3 — 3  in FIG.  2 . 
     FIG. 4 is a perspective view of several of the sealed containers of FIG. 1 stacked on top of each other. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     In the drawings and the description which follow, the container of this invention is generally designated by the reference numeral  10 . FIG. 1 shows that the container  10  has a bottom wall  12  which is joined to a plurality of interconnected, substantially upright side walls  14 ,  16 ,  18  and  20 . Preferably four side walls are provided so that the container has a substantially rectangular shape. However, other shapes are contemplated and will suffice, even a continuous side wall forming a round or oval shape. The side wall(s) extend upwardly from the bottom wall  12  to define an open top  22  therebetween. An optional lid  24  can cover the open top  22 . When a lid  24  is provided, a lip  26  extends around the open top  22  so as to allow the lid  24  to sealingly mount on the top of the side walls  14 ,  16 ,  18 ,  20  of the container  10 . 
     The container  10 , including the lid  24 , are molded or otherwise formed from a plastic material that is slightly pliable. However, the material must be sufficiently rigid to support the placenta  28  horizontal without significant deflection. The material is impervious to fluids. The plastic material is translucent, or more preferably transparent (clear), but opaque material will also suffice if the indicia discussed below are clearly discernible from the inside of the container  10 . In the preferred embodiment, the container  10  is unsterilized and intended to be disposable, but sterilization and/or reuse are also viable options. Furthermore, sterile drapes can be used to handle the placenta  28  if infection is suspected. 
     On one side of the container  10 , for example on side wall  16 , spaced apart visually discernable indicia L are included therealong for measuring the length of a placenta  28 . The indicia L include a set of equally spaced vertical marks, lines or ridges which are numbered for ease of measuring using the scale or system of units desired. The numbers can be arranged to be readable from the inside of the container  10  only, from outside of the container  10  only, or from both the inside and outside of the container  10  as shown. The marks originate from one of the inside corners of the container  10 . Similar indicia W is provided along the second side wall  18 . This second set of marks also originates from the corner between side walls  16  and  18 . The marks on side wall  18  extend perpendicular to the marks on the side wall  16 . Thus, one of the side walls  16 ,  18  can be used to measure the length of the placenta  28 , and the other of the side walls  18 ,  16  can be used to measure the width of the placenta  28 . 
     The third side wall  20  includes two sets of visually discernable indicia H, UD thereon. The first set of indicia H on side wall  20  and the third set overall is a set of marks including short horizontal equally spaced apart lines positioned above the bottom wall  12  of the container  10 . Corresponding numbers are provided adjacent to the marks to show the distance from the bottom wall  12 . These marks are used to determine the height or thickness of the placenta when it rests on the bottom wall  12 . Thus, the length, width and height of the placenta can be quickly and accurately determined using the three sets of indicia described above. Note that the product of the length, width and height does not equal the fluid volume, which the placenta would occupy. The information provided by these individual length, width, and height or thickness measurements potentially highlights any abnormalities, which might exist in the placenta  28 . 
     As best seen in FIG. 2, the placenta  28  has a maternal surface  30  which rests on the bottom wall  12  of the container  10  and a fetal surface  32  which is directed toward the open top  22  of the container  10 . A membrane  34  and an elongated umbilical cord  36  are connected to the fetal surface  32 . The indicia UD on the side wall  20  includes a set of equally spaced vertical lines and at least some numbers corresponding thereto, which indicate the diameter of the umbilical cord  36 . The side wall  20  of the container  10  also includes a bio-hazard warning symbol molded, marked or affixed thereon. 
     Since the use of the metric or international system of units is prevalent in the medical field, the indicia L, W, H, UD and associated numbers are preferably in centimeters (cm) or subdivisions or multiples thereof. The container  10  is preferably large enough to accommodate indicia as follows: L=24 cm; W=24 cm; H=4 cm; and UD=2 cm. Preferably the inside of the container  10  itself is approximately 25 cm long, 25 cm wide, and 6 cm high. Markings reminding the use of the scale or system of units are also recommended. 
     As best seen in FIG. 3, the indicia L, W, H protrude slightly from their respective walls in the preferred embodiment. Here the indicia L, W, and H protrude into the interior of the container  10  to allow them to be viewed with the lid  24  removed, but they could also or alternatively protrude outside the container  10 . Protrusions of approximately 1-5 mm, more preferably about 2 mm, are readily visible. Indicia UD can also protrude if desired. 
     Because the density of the material used to form the container  10  is known and can be controlled closely through conventional production molding processes, the mass of the container  10  is basically known. Even if there is significant variation, the container  10  can be weighed before use. Then the mass of the placenta  28  can be obtained by weighing the full container and subtracting the mass of the empty container. 
     The side wall  14  has three areas  38 ,  40 ,  42  thereon for labeling the container  10  with the day of the week, date, and patient identification information corresponding to the placenta  28  stored therein. Adhesive labels can be utilized or, more preferably, the outer surface of the plastic container  10  can be left slightly rough in the label areas  38 ,  40 ,  42  so that a grease pencil or conventional ballpoint ink pen can be utilized to record the necessary information. 
     The side walls  14 ,  16 ,  18 ,  20  of the container  10  are inclined outwardly slightly so that another container  10  can be stacked on top thereof. With or without outwardly inclined side walls, the container  10  is stackable upon itself when the lid  24  is installed. See FIG.  4 . 
     Following the delivery or removal of the placenta  28  from the mother&#39;s body, the gross placental examination kit (GPEK)  10  provides the following method or methods of examination and storage. A health care professional, typically a nurse, grabs a container  10  and weighs it if the weight of the empty container  10  is not known with sufficient accuracy. The nurse then positions the container  10  so as to receive the placenta  28 . The nurse places the placenta  28  in the container or GPEK  10 . The placenta  28  sits in the GPEK  10  while the nurse finishes other tasks. During this time, blood from many of the blood vessels in the placenta  28  will drain into the container  10 . Then, while carefully holding the placenta  28  in the container  10 , the nurse tips the container  10  over a sink to drain off the excess fluids. Then the nurse orients the placenta  28  in the container  10  with the maternal side  30  resting on the bottom wall  12  and the fetal side  32  facing up. In this position the membrane  34  and umbilical cord  36  can also be examined easily. The net weight or mass of the placenta  28  is documented by weighing the full container  10  and subtracting the weight or mass of the empty container  10 . Elevating the opposite corner of the container  10  causes the placenta  28  or placental disk to slide into the corner of the container  10  which exists between the origins of the indicia L, W. Using the indicia L, W, the nurse determines the length and width of the placenta  28  respectively and documents the results. Sliding or otherwise moving the placenta  28  to the opposite corner allows the nurse to determine the height or thickness of the placenta  28  using indicia H. The maximum, minimum or average height can be roughly approximated. 
     Pulling the umbilical cord  36  in front of the indicia UD enables the nurse to determine its uniformity and diameter, which are then recorded with the rest of the nurse&#39;s observations, if desired. The length of the umbilical cord can also be determined by extending it alongside (adjacent and parallel to) the walls  16 ,  18 . Some simple arithmetic may be necessary. Color and knots can be documented. The number of umbilical cord blood vessels and their integrity can be determined, as well as the umbilical cord insertion on the fetal surface  32 . Other characteristics of the placenta  28  can be determined and documented while the placenta  28  is in the container  10 , including overall shape, type of presentation, overall integrity, abnormalities in color, and smoothness and blemishes. For example, the fetal surface  32  is examined for color, smoothness, and blood vessel integrity. Any extraplacental membranes  34 , which are still attached to the placenta  28 , can be examined too. The nurse palpates the parenchyma (placental disk) to determine and document its consistency. 
     Before or after the fetal surface  32  is examined, the nurse can orient the placenta  28  in the container  10  so that the material surface  30  is facing up and can be examined for intactness and attached blood clots. It is also possible to take some or all of the L, W, and H measurements with the maternal surface  30  of the placenta  28  facing up, as long as it is substantially flat. A consistent procedure should be utilized for best results. 
     The nurse snaps the lid  24  onto the container  10  if the specimen is to be stored after the examination. Copies of the form containing the results of the examination can be distributed to other medical personnel as needed. Labeling the container  10  with the appropriate information in label areas  38 ,  40 ,  42  ensures that the specimen is properly identified and therefore retrievable. 
     In some cases the specimen is sent to a pathology lab for further study. A full thickness strip of placenta and membranes and two pieces of the umbilical cord can be placed in a small container with a preservative, such as formalin, therein and sent to a pathology lab for histologic study. Later, these tissue samples are sectioned, studied, documented and embedded in a block of paraffin which can be retained for 21 years in case of possible birth defect litigation. 
     The containers  10  are typically stacked as in FIG.  4  and placed in a refrigerator for a limited period of time in case further examination, pathology, sectioning or other testing is required. After a predetermined time, such as seven days, the container  10  and the specimen stored therein are disposed of in an appropriate biohazard waste receptacle. The seven day disposal cycle would be particularly advantageous when the refrigerator is divided into seven compartments or shelves, one for each day of the week. After one week, the week-old specimens could be discarded and specimens from the current day could be stored in that space. The biohazard symbol  44  reminds the user of the need for proper disposal. 
     As the above discussion suggests, the container  10  is quite versatile. For instance, it is contemplated that the indicia L, W could be located on the bottom wall  12  of the container  10  rather than on the side(s)  16 ,  18  of the container  10 . Thus, it can be seen that the present invention at least achieves its stated objectives. 
     In the drawings and specification there has been set forth a preferred embodiment of the invention, and although specific terms are employed, these are used in a generic and descriptive sense only and not for purposes of limitation. Changes in the form and the proportion of parts as well as in the substitution of equivalents are contemplated as circumstances may suggest or render expedient without departing from the spirit or scope of the invention.