Document 6426062

Transcription

Document 6426062

NINCDS COLLABORATIVE PERINATAL PROJECT A User's Guide to the Project and Data Volume II: Project Study forms
and Documentation of Transfer
to Computerized Data Items
in Master File
Part C: Pathological Exams and Autopsies December 1983
Prepared for
the National Institute of Neurologkal
and Communicative Disorders and Stroke
under Contract 2311105150
0Ba1telle
Padfic Northwest Laboratories
Reproduced at the National Archives
I
r
This tt'J)Of1
wOK pr~.:red
by B.met&. ~ •n ~ccount of tpemored
te.t'Jtch "'ivltiti, ~•ther Spomor nor &.neol&. nor •ny penon "'*"~
on ll.h•lf of eitht!t:
MAUS .J\NY WAIIIIANn ott ttiNUIHIAnoN. lZNISS CHI
IMPUID. with tnpoc!!(:lto th~ «cur.cy, compt...meM, or UHfulNU of
theo lnform•don c:ont.tint'd in this report. or '"" th~ uw of .,.,. infGftn.t·
tion•.tpp.N.tlut, proceu. or C:GMf)CKtlion dKdOM!d In rhii repcm may not
infrlnte Ffv.ttefy ownt'd rishts; or
~ssumM •n~ lilb4filfM with 'ftf34!<1IO the uw of. or for ch""'ft retUk ~
ln(l ffom the uw of, •nv infCHm.ttton. app.atMui•.woceu, or cornprolttion
diie:IOM'd In this r~t.
NINCDS COLLABORATIVE PERINATAL PROJECT:
A USER 1 S GUIDE TO THE PROJECT AND DATA
Volume II. Project Study Forms and Documentation
of Transfer to Computerized Data Items
in Master File
Part C.
Pathological Exams and Autopsies
NR Hinds
A Brix
JS Littlefield
CR Watson
December 1983
Prepared for
National Institute of Neurological
and Communicative Disorders and Stroke
under Contract 2311105150
Battelle
Pacific Northwest Laboratories
Richland, Washington 99352
INTRODUCTION DOCUMENT OBJECTIVES AND READER ASSUMPTIONS
Volume II, Project Study Forms and Documentation of Transfer to
Computerized Data Items in Master File, provides researchers with detailed
documentation for how data were collected, coded and stored on the data base.
Volume II will help investigators decide: if data were collected in a suitable
way for addressing particular research questions; if revision of forms
affected the collection of specific data items; if data were coded on master,
variable or work files, or are available only on microfilm. The reader is
assumed to be the principal investigator for a project in which data from the
data base will be used.
DOCUMENT STRUCTURE
Because of its size, this volume is divided into ten separate parts, each
containing material on a group of forms related by subject. Each part groups
together similar study forms. Generally, a part covers a single time period.
The parts do not correspond exactly to the hierarchical classification
structure described in Volume I. The parts of Volume II include:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
Prenatal Record and Medical History
Labor and Delivery
Pathological Exams and Autopsies
Family and Socioeconomic History
Neonatal Exams and Observations
Pediatric and Neurological Exams, Four Months - One Year
Pediatric Neurological Exams, Seven Years
Psychological Exams, Eight Months
Psychological Exams, Four Years and Seven Years
Speech, Language and Hearing Exams, Three Years and Eight Years (Final)
This part of Volume II contains Part C: Pathological Exams and Autopsies
and includes Forms PATH-1, PATH-2 and PATH-3.
II.C.iii
To allow easy access to the data as they appear on the master file, all
documentation for each form or form grouping representing a card series on the
master file is identified by form number appearing at the bottom of each page.
Forms are arranged in what may appear to be illogical numerical order in some
cases, but the arrangement presented here ties forms and their revisions
together and allows an investigator to trace an item through all revision
cycles. Thus, in Part A of Volume II, OB-42 follows OB-9 and OB-10 appears
next to OB-44 and OB-45. (For an explanation of how the master file was
organized to result in this ordering, see the next section of the Introduction.)
All material related to a form is organized as a single unit within each
part of Volume II. The material included for each form is given below in the
order it appears:
• Descriptive Summary of Form. Includes purpose of form, history of use,
revisions and location of records stored on Master File. A table is
provided for each form (except those on microfilm only) showing the
number of records available for each revision.
• Data Items Referencing Form. A list of all data items in computer
files originating from form. List ordered by data item identification
with reference to item number on form.
• Form.
Copy of last revision of form.
• Form item numbers linked to data items. A list organized by form item
numbers of all computerized data items originating from the form.
• Definition of codes. Coding instructions detailing the codes assigned
to each computerized data item from the form.
• Master File Card Image.
File card.
Illustrates transfer of data on form to Master
• Instructions for Completing Form. The instructions used by study
personnel to complete the form for each case.
• Earlier Forms or Manuals. Copies of earlier versions of forms or
manuals that were used during the study.
MASTER FILE ORGANIZATION AND REVISION OF FORMS
Some understanding of how the master file was organized should aid
investigators who want to trace the entry of data into computerized study
files. The numbering system used both on forms and cards provides information
on how data may be retrieved from the master file.
II.C.iv
Forms
The first forms used in the study were the OB forms; as a consequence,
this group of forms underwent the most revision. At first glance, it appears
that forms disappear from the file and reappear in strange or bewildering
places. In actuality, revisions were made according to a specific method.
Two types of revision and subsequent recodes appear in the master file,
both of which appear in the OB series. In the first type of revision, radical
changes in the concept of a form created a need for new coding in the computer
file. Form OB-9, for example, was replaced by forms OB-40 (an optional form
retained by the institution), OB-42, and OB-43 in April 1962. Data for earlier
patients were recorded on OB-9 and entered on cards 1309, 2309, 3309 and 4309
of the master file; after April 1962, data was recorded on OB-42 and OB-43 and
were entered on cards 0342, 1343 and 2343 of the master file.
In the second type of revision, the Collaborative Perinatal Task Force
considered revisions important enough to warrant the distinction of a new form
number, but considered the data for both forms to be similar enough to allow
combining of data from both the old and new forms on the same card series. An
example of this type of revision is form OB-35, replaced by OB-57 in April
1962. Records for both OB-35 and OB-57 are entered on cards 0357, 1357, 2357,
3357, 4357, and 5357 in the master file.
In assigning numbers to forms and their revisions, designers of the study
followed a plan: prenatal records, history, and summaries of the prenatal
period received numbers 1 through 15; when revised, these forms were assigned
numbers in the forties. Labor and hospital records appeared on the 30 series
of forms. When these forms were revised, they were assigned numbers in the
fifties. Some OB data in the master file were abstracted by NINCDS staff
members from forms filled out at the hospital. Cards derived from this
procedure were designated as coming from forms ADM-49, 50 and 51 (which were
actually ABSTRACT SHEETS). Autopsy protocol and laboratory exams of the
placenta were recorded on forms PATH-1, PATH-2 and PATH-3.
Forms for recording family health history and genetic information during
pregnancy also received a fair amount of revision. Early records appear on
forms FHH-1,2,3 and 4. With revisions in April 1963, form SE-1 replaces part
of FHH-1 and FHH-3; FHH-2, FHH-4 and parts of FHH-1 and FHH-3 were replaced by
II.C.v
forms GEN-5 through GEN-8 in May 1961. Form FHH-9, initiated in November 1965
for collection of socioeconomic data at time the child was seven years of age,
was not replaced or revised.
The PED series of forms underwent little revision. Records for newborn
babies appeared in PED-1 through PED-8; records for children up to age one and
interval records were placed on PED-10 through PED-29. Seven year records were
included in the series numbered PED-74 and up. Only one pediatrics form was
radically revised: PED-7 was replaced by PED-8 in March 1963.
No replacements occur in the PS series, where results of psychological and
speech, language and hearing tests were recorded. The PS forms are divided
into distinct groups based on time of testing and subject of testing.
Psychological testing occurred at 8 months, 4 years and 7 years; speech,
language and hearing exams were administered at ages 3 and 8. Only the 8 month
psychological examination underwent substantial revisions.
Master File Card Number and
NINDB Case Number Rationale
Computer cards for each NCPP study form are numbered to reflect their
origin and possible revisions. Card numbers are assigned to identify the type
of data (subject), the presence of multiple cards in a series, NCPP study form
and form revisions. The first five digits of each card on the master file are
the card number. The study forms and card numbers are given in Figure 1.
The first fourteen columns of each master file computer card contain the
master file card number and the NINDB case number. Table 1 identifies the
function of each of these columns.
Column 1 identifies multiple cards in a series. It contains a zero for
cards unique to a particular form (that is, no other cards are present), for
example OB-3, or for cards where repetitive data are contained. Cards for
OB-2 are an example of this second type; no new categories of information are
included on successive cards, but previous births in excess of four must be
recorded on an add-on card. For card series where data entered are unique to
a card and more than one card is required to complete the series, a 11 111 is
used to designate the first card, for example OB-5. OB-57, PATH-2 and PED-14
are exceptions to these rules.
II.C.vi
AA-1
08-2
083
08-4
08-5
088
081
08·8
089
IRepl.:ld by 08 43)
01·10
OB-15
08·JJ
I Replaced by 08-451
08-34
IRitplaced by 08-551
0835.08-57
08Je
0831
08·38
(A0.. 491
(ADM-SOI
fADM-511
08-42
08-43
....... .......
n
<
......
0844
f~tll
Vttit
......
08-45
fReplacn 08-101
08-55
(Replecn 08-341
0858
08 51-52
08·58
08·00
FHH 1.3
IReplaced by SE H
SE·l
FH!-19
fRepl.:n FHH I, 31
GEN-5 8
PE0-6
PED 7
PEDB
PS-1-5
PS-10.17
PEO 10
PEO 11
PED 12
PEO 14
PEO 75
PE0-78
•New Cerd Types
••on DNB copy of the mnter dlt• tale only
PS·:Ie
PS-20-25
FIGURE 1.
PS-l0-38
PS-4045
Cards on the Master Data File
•peo-n
TABLE 1. Derivation of Master File Card Number
and NINDB Case Number.
Columns
Contents Master File Card Number
card identifier
general subject matter
form number
revision code
NINDB Case Number
collaborating institution
type of patient selection
gravida identification number
order of the pregnancy
identifies child or gravida
1
2
3-4
5
6-7
8
9-12
13
14
The second digit on the card reveals the general subject matter covered by
data on the card. All cards containing information pertaining to obstetrics,
for example, are designated by a "3" in column 2; family histories are
designated by a 11 511 ; pathology with a 11 211 ; pediatrics, with a 11 411 ; and
psychological testing with a "1".
Columns three and four reveal the form number. In the case of forms where
old and new forms having different numbers are included together, the number of
the latest form appears on the master file. This rule does not apply to data
abstracted from several forms by NINCDS staff (ADM forms).
Column 5 of the card contains a revision code indicating which form or
combination of forms was used in arriving at data on a particular card. A
typical card will have one to three revision codes, with a zero indicating the
first version of a form and "1", "2 11 , and "3" indicating later revisions. As a
rule, revision codes used on cards differ from card to card; investigators
should check the definition of codes provided in Volume II to determine the
meaning of revision codes used.
Each woman and child studied in the project received a unique case number
(NINDB case number) composed of nine digits, recorded in columns 6 through 14
of all master file cards. The case number identified the institution, the
mother and the child. The first two digits represented the collaborating
institution (see Table 2). The third digit indicated the type of patient
II.C.viii
selection. A ''1" was used for patients selected for the central core study; a
"6 11 indicated that a patient had been transferred from one institution to
another, and a 11 7" indicated that the patient was part of a special study
undertaken by the collaborating institution. The fourth through seventh digits
were used to identify the gravida, while the eighth digit identified the order
of the pregnancy of a given gravida in the project. The ninth digit was used
to identify the gravida or child of the pregnancy; "9" indicated the gravida,
"0" indicated the child of a single birth, "1" indicated the first child of a
multiple birth, "2" indicated the second child of a multiple birth, etc.
TABLE 2. Collaborating Institutions and Their Code Number
(Columns six and seven of all master file cards.)
OS - Boston, Massachusetts
Harvard Medical School
Boston Lying-In Hospital
Children's Hospital Medical
Center
10 - Buffalo 1 New York
Onivers1ty of Buffalo
Children's Hospital
15 - New Orleans, Louisiana
Char1ty Hospital
Tulane University School of
Medicine Medical Center
Louisiana State University
50 - Minneapolis, Minnesota
University of Minnesota Hospital
Health Sciences Center
55 - New York, New York
New York Medical College
Metropolitan Hospital
60 - Portland, Oregon University of Oregon Medical School
66 -
Philadelphia~ Pennsylvania
University o Pennsylvania
Pennsylvania Hospital
The Children's Hospital of
Philadelphia
32 - New York, New York
Columbia University College
of Physicians & Surgeons
Columbia-Presbyterian
Medical Center 71 - Providence, Rhode Island
37 - Baltimore, Mar~land
The Johns Hopk1ns University
School of Medicine
The Johns Hopkins Hospital
82 - Memphis 1 Tennessee
Univers1ty of Tennessee
College of Medicine
Gailor Hospital
Brown University
Child Study Center
45 - Richmond, Virginia
Virginia Commonwealth
University
Medical College of Virginia
II. C. ix
Data Item Identification and Naming
The NCPP data base contains over 6700 different data items and blank
filler locations on computer files. We have assigned each of these a unique
identification and a terse, stylized name. Because names were chosen to
facilitate use of this guide, they do not duplicate names used by NINDB during
the active phase of the project. Users should consult appropriate
documentation before using data items from the master, variable or work files
(Volumes II, III and IV).
The data item identifiers consist of 11 characters. At the far left are
four unique numbers that were assigned sequentially. The next character is
always a period and is followed by up to six characters. For data items on
the master file, these characters describe the data collection form from which
a data item was derived; for data items on the variable (VAR) or work (WXX)
files, these characters indicate the appropriate file. If the right side is
less than six characters, periods are inserted as shown in these examples:
850 .. OB-34
3650.PATH-3
5223 .... VAR
6340 ... W-10
an
an
an
an
item
item
item
item
from OB-34; on the master file
from PATH-3; on the master file
on the variable file
on work file 10, Rupture of Membranes
We assigned the numbers sequentially as they appear in Volume V. For the
master file, we followed the order in which the cards would be found within an
NINDB case. All card columns are accounted for by one of our data item
identifications. For the variable and work files, the numbers were assigned
in the order that data items appear within a case.
We categorized each data item according to the person to whom the data
refer, by the time of measurement and/or the time to which the item applies and
by general type or subject area (Table 3). Then we assigned names to the data
items using the following guidelines:
• The name and the three associated categories had to stand alone
they must describe the data item out of context.
• The first word in the data item name had to be an important or key
word when all names were listed alphabetically as in Volumes VI and VII.
Thus 11 Cry, abnormal 11 was used rather than 11 abnormal cry 11 because a
II.C.x
researcher is more likely to look for this item under 11 C11 than under
11 11
A in an alphabetic list.
• Secondary key words were preceded with a semicolon11 to facilitate
preparation of the permuted index. For example, abruptio; placenta 11
wi 11 be found under both the 11 A11 and 11 P11 portion of Volume VI.
t Qualifying words are delimited by commas and will not appear as
keywords in Volume VI. Thus 11 abruptio; placenta, degree 11 will not be
found in the 11 011 section.
• If medical terminology or usage has changed since the study was
conducted, modern terms may be included and will be enclosed in
brackets. Thus 11 mongolism; [Down's syndrome] 11 will appear under both
the 11 M11 and 11 011 portions of Volume VI.
• If measurement units are associated with a data item name, they are
enclosed in parentheses and placed at the end of the name as in
11
Birthdate {yr) ...
• The categories {person, time and subject) are appended to the right of
the data item name.
Definitions for each category used in naming data items are given in
Table 4 at the end of this introduction. Additional information is found in
Chapter 4 of Volume I.
Data item names thus assigned are terse and highly stylized; as we have
already indicated, they are not the names used by NINDB during the active phase
of the project. Our aim was to develop standardized names that would stand
alone. These names are intended to facilitate a user's search for data items
potentially useful in a research project. Before an item is used, a researcher
should consult its complete description. For a data item from the master
files, e.g., 850 .. 08-34, the data item should be traced to the appropriate
study form, e.g., OB-34, located in Volume II. A variable file data item,
e.g., 5223 ..•• VAR, is traced to Volume III, where it is defined and its
original source given. A data item from a work file is traced to Volume IV for
its description.
Some data items contained in the indexes may include the notation 11 00 NOT
USE. 11 These items are either inaccurate or an alternative data item is
available that gives better information. Users will find more appropriate
data items by consulting one of the indexes to the data items {Volumes, V, VI
and VI I).
II.C.xi
Tables of Data Items:
Column Headings
For each form, two sets of computer generated pages list all data items in
either the master, variable or work files derived from this form. These lists
enable a user to track form items to computerized data items listed in other
volumes of the User's Guide and vice versa. The computer listings have the
following information.
Column Heading
Description
DATA ITEM ID
A unique identifier for this data item.
See Data Item Identification and Naming
above for details.
ITEM ON FORM
An identifier used on the NCPP study form to
identify the question or group of questions
which was used to generate this data item.
CARD NUM
Identifies the master file
this data item is located.
Card Number and NINDB Case
above for a description of
FROM
Beginning card column for this data item.
TO
Ending card column for this data item.
DATA ITEM NAME
Terse stylized name for this data item.
See Data Item Identification and Naming
above for details.
card on which
See Master File
Number Rationale
card number.
ASSOCIATED DOCUMENTS
By examining the tables provided for each, investigators will be able to
determine which computer files contain data of interest. For data contained in
the variable file, see Volume III of this guide; for data contained in work
files, see Volume IV.
II.C.xii
TABLE 3.
Abbreviations for Person, Time and Subject Categories
Person
Time
Subject
Mother
Father
Placenta
Fetus
Child
MSurrogate
Family
Sibship
Ceneral
Preconception
Registration
Prenatal
Admission
Intrapartum
Delivery
Post Partum
Neonatal
Four month
Eight month
One year
Three year
Four year
Seven year
Eight year
Administrative
Anesthesia
Clin. Impression
Cl i ni ca 1 Lab
Current Pregnancy
Environ. Exposure
Events
Hearing
Hospitalizations
Language
Linkage
Malformations
Diag. & Cond.
Med. History
Medications
Neurological Exam
Observations
Pathology
Phys i ca 1 Exam
Procedure
Psych. Exam
Reproductive Hist.
Serology
Socioecon. Info
Speech
Vision
Work History
X-ray
Summary
Cyn. History
Special Studies
Fam/Cenetic Hist.
SLH Exam
II.C.xiii
TABLE 4. Definition of Person, Time
and Subject Categories
PERSON DEFINITION
Mother Study registrant bearing the "study pregnancy"; biologic mother of the "study
chi 1d"; gravida.
Father Biologic father of the study child or study pregnancy; in the case of
socioeconomic data, this category may indicate either the "father of baby" (not
necessari 1y husband of the mother) or the "husband" (not necessarily re1ated
biologically to the study child).
Placenta The organ of metabolic and gaseous interchange between the fetus and mother; also
included in this category are gross and microscopic pathologic data from
examination of the umbilical cord.
Fetus Conceptus; the product of conception including the embryonic stage, i.e., from
conception to the moment of birth.
Child Product of the study pregnancy from the moment of birth onward; study child.
M Surrogate Person or persons substituting for the mother of a study child, e.g., adoptive
parents, foster parents or guardian.
Family Person or persons biologically related to the mother or father of the study child.
Sibship Child or children having one or both of the same biologic parents as the study
child; siblings; half siblings; full siblings.
II.C.xiv
TABLE 4. Definition of Person, Time and Subject Categories
(Cont.) TIME
DEFINITION
General
Data with no pertinent time period or data pertaining to more than one time
period.
Preconception
Data pertaining to the period prior to conception of the study pregnancy.
Registration
Data collected at the time of study mother's registration in the study.
Prenatal
Data pertaining to the period from conception of the study pregnancy to
delivery of the study child.
Admission
Data collected at the time of study mother's admission to the hospital for
delivery of the study child.
Intrapartum
Data pertaining to the period from admission for delivery or onset of labor
to delivery of the study child.
Delivery
Data pertaining to the time period during which delivery of the study child
occurred.
Post Partum
Data (pertaining to the study mother) collected during the period immediately
following birth of the study child.
Neonatal
Data pertaining to the study child during the period from birth to one month
of age; the majority of these data were collected prior to or at the time a
study child was discharged from the hospital.
Four Month
Data collected at the time of the four month examination of the study child.
Eight Month
Data collected at the time of the eight month examination of the study child.
One Year
Data collected at the time of the one year examination of the study child.
Three Year
Data collected at the time of the three year examination of the study child.
Four Year
Data collected at the time of the four year examination of the study child.
Seven Year
Data collected at the time of the seven year examination of the study child.
Eight Year
Data collected at the time of the eight year examination of the study child.
II.C.xv TABLE 4. Definition of Person, Time and Subject Categories
(Cont.) SUBJECT
DEFINITION
Administrative
Data pertaining to the administrative aspects of the study.
Anesthesia
Data on medications and procedures used to obtain anesthesia.
Cl in. Impression
Impression of abnormality or dysfunction gained by an examiner
following evaluation of clinical signs and symptoms and including a
subjective component.
Clinical Lab
Data obtained from laboratory examination of clinical specimens.
Current Pregnancy
Personal data and medically relevant information pertaining to
the study pregnancy for which the mother is enrolled.
Environ.
Exposure
Data on exposure to occupational or other environmental entities
or hazards.
Events
Data related to a specific event, occurrence or incidence.
Hearing
Data obtained from examination and testing of hearing function.
Hospitalizations
Data on specific hospital admissions or the number of hospitalizations.
Language
Data obtained from examination and testing of language function.
Linkage
Data on the genetic relationships of family members to the study
mother, father or child.
Malformations
Data on the conditions in which failure of normal development has
resulted in abnormal physical traits existing at the time of birth.
Diag. & Cond.
Data on specific diagnoses or conditions obtained from past
medical history or examination during the study.
Med. History
Data obtained from the study participant or medical records relevant to
past or current medical diagnoses or conditions.
Medications
Data on drugs or medications used.
Neurological
Exam
Data obtained from observation and physical examination
of the central nervous system.
Observations
Data obtained from observations not categorized elsewhere.
Pathology
Data obtained from clinical and anatomical
pathological examination.
Physical
Exam
Data obtained from physical examination of the
study participant.
Procedure
Data relating to specific procedures performed on the study participant
prior to or during the period of enrollment in the study.
Psych. Exam
Data obtained from the psychological examinations and observations.
I I. C. xvi
TABLE 4. Definition of Person, Time and Subject Categories. (Cont.) SUBJECT
DEFINITION
Reproductive
Hi st.
Data pertaining to the outcome of pregnancies prior to and or during
the period of enrollment in the study.
Serology
Data obtained from the laboratory examination of serum by specific
immunologic methods.
Socioecon. Info
Data related to the social and economic characteristics and environment
of the study participant.
Speech
Data obtained from examination and observation of speech function.
Vision
Data obtained from examination of the eyes.
Work History
Data pertaining to occupation and employment prior to and during the
period of enrollment in the study.
X-Ray
Data on diagnostic x rays and diagnostic or therapeutic radiological
procedures.
Summary
Data presented as a summary of data collected and recorded elsewhere.
Gyn. History
Medical history specifically related to the female genital tract,
reproductive physiology and endocrinology.
Special Studies
Data pertaining to participation in other special organized studies
conducted during the period of enrollment in the study.
Fam/Genetic
Hi st.
Data on the medical histories of family members genetically
related to the study child.
SLH Exam
Data obtained from the speech, language and hearing examinations not
specifically or exclusively related to one of these areas.
II.C.xvii
CONTENTS PATH-1
Placental Exam - Gross
II.C.l PATH-2
Placental Exam - Microscopic
II.C.31 PATH-3
Autopsy Protocol
I I. C. 53 Reproduced at the National Archives
II.C.xix
PATH-1
Placental Examination - Gross
Form PATH-1 was used to provide precise and detailed information about the gross appearance of the placenta and how it might relate to the outcome of the pregnancy for both mother and infant. THe form was implemented in July 1959 and was not revised. Data from PATH-1 were keypunched onto cards 1201 and 2201 in the master file (Table PATH-1.1). TABLE PATH-1.1 Cards and Data Records by Revision for Form PATH-1 CARD REV.
NUMBER NO.
CARD NAME
PATH-1: Dimensions, Cord, Memrane and Fetal Surface
NUMBER
RECORDS
1201 2
3
47,290 1,488 48,778
PATH-1: Maternal Surface, Cut Surface
2201 2
3
47,177 1,493 48,670
tota I for form
II.C.l
97,448
PA'IH-1
II.C.2
PATH-1
Oata items
Reterencin~
DATA
UF.N
1TE114 JN
FJRM
TO 48 •••••••
49 •••••••
.. w
H
H
()
"iO.PATH•1
2
~1.PATH•1
3
3
3
Form PATH•l, Placental
Fx~m
- Gross
CARD
NUM
1201
1201
1201
1201
1201
1701
1201
1201
1201
1201
1701
1201
1201
1201
1201
1201
1201
12ot
FROM
1
6
TO
DAfA trF.M NAME
5 Card number (sequence, foru tvoe, form number, revision number)
14 NTNOB case number
21
22
1201
1201
1201
1201
11.01
1201
1201
1201
1201
51
52
51
16 PatholoovJ ornss,
20 Patholoov: oross,
22 P~tholonvJ orns~,
24 P~tholo~v: qrnss,
7b Patholonv: nrnss,
11 ~atholooy; nross;
78 PatholonyJ qross;
79 Patholonv: oross;
30 Patholo~y; qross;
12 P~tholo~y; oross;
34 Patholoov: oross;
36 Patholooy; qross;
17 P~tholoovJ nross;
38 Patholoqy; nrossr
41 P~tholoqy; qrnss;
43 Patholoqy; oross;
to placental
44 Patholooy; nross;
45 Patholoqy; orossr
46 Patholooy; orossr
47 Patholoov: ornss;
48 Patholoqy; oross;
49 PathoJoqy; oross;
50 Patholonv: nross;
51 Patholoov: oross;
52 Patholoov: nross;
~3 Patholoov: oross;
76.PATH•t
23
1201
54
55 Patholoov: oross; •embranes an~ fetal surface, shortest distance
71.PATH•1
24
1201
56
78.PATH•1
79.PATH•1
RO.PATH•1
25
26
27
1201
1201
57
5R
11.01
5Q
A1.PATH•t
28
1201
60
R2.PATH•1
Rl.PArH•I
2q
30
1201
1201
62
"2.PATf.l•t
5l.PATH-1
54.PATH•t
55.PATH•1
56.PATH•1
57.PATH•1
58.PATH-1
7
8
~9.PATH-1
9
60.PATH•I
f)1.PTITH•1
fi2.PATH•t
fi3.PATif•t
64.PATH•1
65.PIITH•1
9
9
9
66.PATH•t
67.PATH•1
fi8.PUH•1
69.PATH•1
70.PATH•I
1l.PAIH•1
12.PATH•I
73.PArH•t
14.PATH•1
75.PATH•1
13
14
15
lfi
17
3
5
6
12
13
19
20
1201
15
17
21
23
2"i
27
2R
29
31l
31
33
3'5
37
3R
H
41
44
45
46
47
4q
4Q
so
exa~inatlon
bV
ti1e
~ate
C~o>
1ate (d~y)
date Cvr>
~esiqnatlon of placenta, plurality
placenta, labeled at ~ellverv
placenta, fused
placenta, anastomosis present
olacenta, 1tmenslons, laroest diameter Ccm)
placenta, jl~ensions, s~allest dia•eter (em)
placenta, dluensions, tnic~ness Ccml
placenta, shape
placenta, description
placenta, lenoth Ccm)
placenta, shortest distance fro• cord, Insertion
marqin Ccm)
placenta, type of insertion
placenta, n~mber of vessels
placenta, true ~not
placenta, color
placenta, fro7.en sections ta~en
1embranes and fetal surface, description
~embranes and fetal surface, me~branes complete
~embranes and fetal surface, decidual necrosis
•embranes and fetal surface, •e•branes edeMatous
we~branes an~ fetal surface, insertion of
~embranes
i
~
61
frnm edge of
56 PatholoqyJ ornss;
surface
57 PAtholoov: oross;
58 Patholoov: ornss:
59 P~tholoqy: ~ross;
suhchorionlc
60 Patholoqy; qross:
vessels
61 Patholo~v: oross;
~2 Patholonv: nross:
rupture to Placental mar~ln <c•l
~embranes and fetal surface, color of fetal
~embranes
•e~branes
and fetal surface, opacity of membranes
ani tetal surface, subchorionic fibrins
uembranes anj fetal surface, description of
fibrin
~e•branes and fetal surface, thro•bosed fetal
•embranes and fetal surface, a•nion nodosuM
~embranes anj fetal surface, cysts
~ata
Items
RPterencl~Q
DATA
ITEM
TrEM
Jill
TO
FJRM
R4.PATH•l
3t
85 •••••••
Ab.PATH•t
fit 7 • ••••••
AB •••••••
A9. PATH•l
CIO.PATH•t
IJt.PATH•t
ll2.PATH•t
form PATH•l,
CIIRO
NUM
1201
11.01
1201
2201
2201
2201
fROM
61
67
71
1
6
Pl~cent3l
P.x~~
- Gross
TO
OATil
TfEM NAME
66 PittholOilY: Qross; ~e~branes anj tet8l surf8ce, weiqht (Q~S)
72 I:Hank
AO Patholoqv: qross; olacenta 11entification nu~ber
5 Card number (sequence,
14
NtNnR c8se
for~
type, form number, revision
nu~ber)
nu~ber
to;
15 Patholoqy; qross;
~aternal
surf8ce, intact/lacerated
2201
11\
1~terna1
surf~ce,
co~pleteness
17
surt~ce,
lit
19 PittholOQVf Qross;
(em)
~aternal
3fi
2201
2201
~aternal
surface,
depressed area, total nu•ber
depresse~ area, size, lenqth
IJ3.PIITH•1
3fi
2101
20
21 Patholoavr qross; •eternal surface, depressed area, slae, width
9t.PA TH•1
CJS.PATH•1
CI&.PATH•1
J1
2201
22
38
JIJ
2201
2201
24
H
H
IJ7.PATH•t
]CI
2201
26
()
CI8.PIITH•1
H
2201
2A
99.PArH•I
40
2201
30
100.PIITH•1
40
2201
32
lOl.PIITH•I
tn:.!.PATH•t
10l.PATH•1
104.PATH•t
lOS.PATH•t
10b.PATH•1
107.PATH•I
43
41
41
2201
2201
34
36
2201
2201
37
2201
2201
H
40
41
108.PATH•I
tn9.PATH•I
44
44
2201
2201
42
41
22 Pfttholoavr aross; •atPrnal surface, depressed area, apparent cause
2J P8tholo1vr aross; •eternal surt8ce, ne•orrnaqe, aqe
25 P~tholoavl qross; ~8ternal surface, he•orrna~e, slze, laraest
di8mPter (Cm)
27 P~tholoQy; oross; maternal surface, hemorrh!~e, slze, sMallest
1iameter (C~)
1.9 PathoJoqy; aross; ~eternal surtace, hemorrhage, size, thic~ness
(em)
31 PAtholoqy; aross; •sternal surface, hemorrhage retroplacental
shortest ~lstance trou peripheral edae he•orrh8~e to placental
m8r~tn <c•1
33 Patholo1v: arnss; •at~rnal surface, hemorrnsge retro•e•br8nes
snortest ~lstance tro1 oerloheral ed~e ne•orrha~e to placental
mar1tn (em)
35 Patholoav: aross: cut surfa~e infarcts, tot!l nu•ber
16 Patholoqy; aross; cut surface, Infarcts, oink/red, •ar~in8l
37 PBtholoqy; aross: cut surface, Infarcts, oink/red, not mar~inal
18 P~tholoov: aross: cut surface, Infarcts, vellowlwnlte, marginal
19 Patholoqy; qross; cut surface, tnfarcts, vellowlwhlte, not ~8r~inal
40 PatholoQVJ aross; cut surface, infarcts, pink/red, unknown location
41 Patholoqy; oross; cut surface, Infarcts, yellow/white, unknown
location
42 Patholoav: Qross; cot surface, inf8rcts, unknown color, maralnal
43 P~tholoqy; aross; cut sorface, Infarcts, un~nown color, not
110.PATH•t
44
2201
44
44
11l.PIITH•1
1t2.PATH•1
lll.PIITH-1
114.PIITH•1
45
46
47
4R
.
•~
~
I
....... 33
H
35
44
44
44
44
Ccm)
2201
23
311
2201
4'5
2201
46
47
4R
2201
2701
~arqlnal
P~tholooy: ~ross:
cut surface,
location
45 Patholooy: aross; cut surface,
46 Pathotoav: qross; cut surface,
47 P~tholoay: ~ross; cut surface,
48 P~tholoav: aross; cut surface,
infarcts,
un~no•n
color, unknown
Infarcts, slze (em)
Infarcts, ~aternal floor
color
CJnststencv
.
H
H
(')
0
l.11
nata
lte~s
Referencl~g
For~
PATH-1,
Pl~cental
rx~n
- Gross
nr.M
DllfA
lTI!:M
Jill
TO
F"JRM
115.PAfH-t
116. PATH-I
48
lt7.PATH-t
CARO
NUM
FROI4
TO
DA
fA
llEM NAME
2?.01
2201
49
49
51
P~tholo~y;
~0
50
2101
52
52
1 t8.PUH-1
51
2201
53
53
119.PATH•I
52
2201
54
54
120.PATH-1
53
2201
55
55
1'-l.PATH•t
122.PIITH•1
12l.PUH•1
124.PATH•1
125.PATH-t
12b.PATH•t
127.PIITH•1
54
55
56
511
5q
60
5
2201
2201
2201
2201
2201
2201
2201
56
57
56
~rossJ cut surf~ce, intervillous thrombosis, total
number la~tnated
Patholooy; oross; cut surface, Intervillous thrombosis, number
laminated In •arginal sinus
P~tholoov: oross1 cut surface, Intervillous thrombosis, total
number not la•inated
P~tholooy: ~ross; cut surface, Intervillous thrombosis, number not
laminated in maroinaJ sinus
P~tholooy; oross; cut surface, tumor
P~tholoov: oross; cut surface, hydatid chanqe
Patholoay; oross; cut snrface, true cvsts
Patholoov: oross, exam was done -ith knowledge of case
PathoJooy; oross, special studies
PathoJooy; oross, other abnor•allties
Patholoqy; oross: desiqnatton of Placenta, olurality
»lanK
P~tholooy; aross, placenta tdentiflcatton number
P~thoJooy; oross; nembranPs and fetal surface, color of fetal
surface
Patholoov; oross: membranes and fetal surface, decidual necrosis
P~tholooy; oross; membranes and fetal surface, decidual necrosis
(yes, no, unKno-n)
Patholo~y; oross; membranes and tetal surface, insertion of
membranes
Patholooy; oross: membranes and tetal surface, weight; placenta
Cqms)
P~thoJoay; oross: nembranes and fetal surface, weight, cataoortaed
Patholooy; oross; cord, type ot tnsertton, membranous, deqree
Patholooy; oross: cord, tvoe ot l~sertion, me•oranous I
P~tholoqy;
orossJ cut surface, calcification
~ross; cut surface, intervillous thrombosis, total
nu•bPr
~7
511
~8
59
60
59
61
62
63
72
80
518
62
P~tholoov:
129.PIITH-1
5l60 •••• VAR
24
&1
64
H
51 A
!'il61 •••• VAR
Sl62 •••• VAR
20
20
51q
S20
519
520
Sl6l •••• VAR
22
"\21
521
5364 •••• VAR
31
52?
525
5365 •••• VAR
5J66 •••• VAR
53f;7 • ••• VAR
31
13
11
"'i26
5211
52q
527
528
529
5l68 •••• VAR
5J69 •••• VAR
14
45
530
S31
510 PatholoQy; cord, arteries, number
511 PAtholoov: oross; cut surface, tnfarcts, site
1?8 •••••••
2?.0 t
2201
non~emhranous
~~ 1. PATIENT'S IDENTII'ICATION
COL,..JZD-t .......
P1..ACEHTAL EXAMINATION -
GROSS
of-
•---~ 1.......
INSTRUCTIONS, (I) F'w- -
Ia 16.5 CM.- ....... ( . . . . . . ._ , . . . 20 .....,. (2) Pl•c.tt~~-- ......... when ...mtnN. (3) An efttry Ia r~ub·H f• ••_,.
for tw'n• only. (4) O.ecrtM all at.nonMiltlea In tfte .,... et ....._fill
.-a .h. .t. (5)
c................
it......,.._ ,,.,.,. . . . . . ., 3 . . . . . . . . . . ., . .......... - · ·
,..u•.-,......... 2. GADS$ EXAMINATION liT
3. TIMI!
: DATE
AM;
Me. ; .,_:
i
i
PM;
v-
.,._of
-ltl,le ~...... • 3S- ....., 6. I.AII!I.ED AT DELY. 7. PLACENTAS I'USED
4. MUI. TIPI.I! BIATHI , ................
5. DESIGNATION 01' PLACENTA DESCAIIII!D ON TNII I'OIIM
9 Twlo A 9
y
TwM 8
c-...
OtNr Mooltl... Blrtlo
I. II' F'USED PI.ACENTAS, IS ANASTOMOSIS PAES!NT?
0a N• 01 Y.. Da IJMMweoloeol (Ve..
elo - - . . . . . . . . . . . . . . . In - 1 ) . - - - - ...._, 1••11-t.t
.,._, te ...-y, .... , . - - . • .-ry .. ¥elft• .._. • ' - ef ............ II. CORD
13. SHOin'UT DIITANCI I'IIOM CDIID INIIIITIDN TO PLACENTAL MAIIGIM
12. LENGTH OF' CORD
(P_...,. . ......_. . . . . . . . . ,Iuaeny
----
IMH pl..:ea)
14. NUMBI!A 01' Y
(P_I_.)
av••
9"'___ ........_ 9 " ' -
(If ..,...................
•-HIM .. - ' !
11. MI!._IIAMU AND I'ITAL SURI'ACE
20. DI!CIDUAI. NECIIOSII
21. MI._IIAMES ID MATDUS
'
·-·
ONetT.
_...,
9~=-' ~-...
22. INSERTION 01' -RANIS ( . - twe If .."Jell
y ,._...,., 9 c - , 1 _ y C l _ l _
,..
fiNe c;JY..
2L SHOIITI!ST DIITAMCa JIRCIIII EDGI 01' RUPTUIIE TO
PI.AC!MTAL MARGIN
9
9 - 9 _,.....,.,._ 9a...cs-lfrl
Bl-
26. SUBCHORIONIC I'IBAIM
: 27.
:,
O N • - D~ nMIIoolo
~-••i._T
29. AMNION NODOSUM
9 ......
CjJ- "--
C? a
fiDifloee
T
31. WEIGHT
30. CYSTS
iTJN•
9Not- 9':::;(0..
33. SURI'ACE
:
li;J ~

25. OPACITY 01' MIMaltANU
24. COLOR 01' I'!TAL SUIII'ACI
CT·----~----0..
D.MATIIINALSUII'ACI
.
01•'-' O L
'
35. DEPRI!SSED ARIA
~N-
yPN-
31. HEMORRHAGE
N... 0 R -
=::
i
: 36. IF PRI!SENT
37. AI'I'ARIMTL Y CAUSED BY
SI••---X----i
9~=- c;JOI!t.C-MI
0
014
; 39. SIZI! '
X
, (!loatlc) a ~Pirm'i CL.-..at_.I-.)(Siiiiii)
ox.
9_._
t:;Jilo*n
; 4Q. SHORTEST DISTANCE PROM PERIPHERAL EDGI! 01'
:
HEMORRHAGE TO I'I.ACINTAL MARGIN _ _ _ _•
X
(Kw;;;at ...: C[JL.-tt•,...••l•••r•l CjlL...,I•rwt••• ....._.
41. CUT SURI'ACE
'2· I NII'ARCTS, (If n. . . wriN (J in oH blon61:a)
-'3. Pink-Red ln'-cta
No. ,....._1
i ..._ Yei'-"Whllw ...- .
No. Net 11111'111••1-----
i
..... ......._____
~~~~
He.
Net,._...,.,_____
... MATIIIMAL I'LOOIIIMI'AIICTS (oo
·-·-In
ONet- 0"'--CD•••IMI
0
.q. CONSISTENCY
47. COLOR
Q
NOitl'lal
0
0
I
(9. INTERVILLOUS
SO. Totol
-11
'
UnuauaUy light
( ... le) n.,..._
THROMBOSIS: (If ..... _,,. 0 lo
lhdtt~~Nd
54. TUMOR
:;:Nota..,.
55. HYDATID CHANGE
yNoto-
ColloboratiYe R"•rch
p.,inatol Roa..rch B,...dl, NINDB. NIH Bothoaft 14, t.W.
oil~-~
in,_.,,........ ____
51. No. 1••......_..
y=-~
1----
: 52. TeNt ne.
-!
ftet
S6. TIIUi! CYSTS (In
,.. ....,........"".
53. He. ,.. ·-~
--~(If-· write
II.C.6 0)
(PATH· I)
"•a11 o, 2
PA'IH-1
57. PATIENT'S
IDENTI~ICA TION
PUCEHTAt EXAMIHATIOH-GROSS
(ContlnuH)
51. GROSS EXAMINATION WA$ DONI! WITH KNOWLEDGE THAT;
CJCIInlnl c_.•• ot outc.... fer
QCIInlal cowa• • outc- ,_
1 . . . . . . , _ . , . . , . . , . ., , . _ . . ,
a ,..._., ...-., ....a..... a
59. $PI!CIAL $TUDII!$o
D
Ph•-ohy
D
I
Vlrol..y
J:
D
0
D
Hl.....,_iotry
•
I (SPMiel stNM)
60. PRI!SI!NCI! 01' OTNI!R ABNORIIALITII!S
D N e o - - l l t i e o - - ...._ ·-lfleol • ..._
D
OWl"' .. .._IMp of "'• ....
•
Dtlooe (4eoorllteJ
A..._ l l t i M - - ...... ·-lfleol ......
'
61. DI!SC:RIPTION 01' A8NORIIALITII!S C:HI!C:KI!D AND OTNI!R PI!RTINI!NT FINDING$. IDI!NTII'V I!ACH C:DIIIII!NT IIY TNI!
C:Ditiii!I'DNDING NUIIBI!R.
Cell--11
. ..._. ~~-·--I4,1&W.
--.
(PATH-1)
II.C.7 I'AOC 2 OP 2
PA'IH-1 Reproduced at the National Archives
form Item
FnRM
10
IfF: Ill
CAI<O
NUfll
f'ROIII
t2Q.PATH-1 2201
t16.PATH•l 2201
H
50
1201
17.01
1201
1201
1201
1201
1201
1201
2201
1201
120t
120t
1201
1201
1201
1201
120t
1201
4Q
5366 •••• v•R
6"\.P.TH•1 120t
"\2A
42
t3
66.PATH•l
5168 •••• VAR
67.PATH•1
6R.PATH•1
bQ.PA'I'H•1
70.PATH•l
72.PATH•l
H.PATH•l
53&1 •• •. VAR
5lb2 •••• VAR
1201
44
510
1201
1201
1201
1201
1201
1201
45
1
5
5
6
7
8
9
q
q
9
t2
14
14
IS
lb
t7
19
20
~
flAT A
tl
t3
3
1
I
.......
1TE._
ON
to nata Items on PATH-1,
J]
3
•(")
•(X)
lin~ed
7t.PUH•1
86.PATH•l
63.PATH•1
50.PATH•1
SJ.PATH•l
52.PATH•l
54.PATH•1
51.PA'I'H•l
127.PATH•l
55.PATH•1
56.PA'I'H•1
57.PA'I'H•1
5A.PATH•1
59.PATH•l
60.PATH•l
b1.PATH•1
62.PA'I'H•1
64.PATH•1
5367 •••• VAR
2
H
H
~umbers
20
20
21
n
22
74.PATH·l 1201
75.PATH•l 1201
Slbl •••• VAR
7l
lA
1'5
21
21
2'5
1'7
bl
27
28
29
JO
31
H
]5
37
39
529
46
47
4!1
50
51
SlQ
520
52
51
521
TO
Plac~ntal
~Kam-
;ross
DATA JTF:M NAME
!10 Patl'lolortv: aross, placenta fjentification nu~ber
"i1 Patholooy; aross; cut surfsce, lnterv111ous thrombosis, total
number
49 Patholoav: aross; ~embranes and tetal surface, description
90 Patholoav: cuoss; placenta t~entificatlon number
18 Patholoay: aross; placenta, description
16 Patholoay; oross, examination bV
24 Patholoav: aross, date (day)
22 Patholoav: nross, date Cmo)
26 Patholoay: oross, date (yr)
20 Patholoqy; aross, time
63 ~~tholoayr aross1 designation of placenta, pluralitY
27 Patholoav: nross1 destgnatton of Placenta, Plurall tv
28 Patholoay: arossr placenta, labeled at delivery
29 Patholoay: arossr placenta, fusej
30 Patholoayr aross1 placenta, anastomosis present
32 Patholoay: qross; placenta, dimensions, laraest dJa•eter Ccm)
14 Patholoav: aross: placenta, df~ensions, smallest dla~eter (CII)
36 Patholoay: aross; placenta, dimensions, thickness (Cm)
37 Patholoay: aross1 placenta, shape
41 Patholoav: aross1 placenta, lenath (em)
529 Patholoqy; Qross; cord, tvoe of insertion, •e•branous I
non:PPmhranous
528 Patholoav: aross~ cord, tVDf' Of insertion, 'lelllbranous, dearee
43 Plttholoav: aross~ placenta, shortest distance fro• cord, insertion
to placental ~araln <em)
44 PAtholoqy: aross; placenta, type of insertion
530 Patholoqv: cord, arteries, number
45 P"--tholoavr qross~ plilcenta, number of Vf'SSels
46 Patholoqy: qross; Pl<tcenta, true knot
47 Patholoav: aross; placenta, color
48 Patholoav: tJross; place11ta, frozen sections ta~en
so Patholoqy: aross; ~e~branf'S and fetal surface, 111embranes complete
51 Patholoay; qross; :nembranes and fetal surface, decidual necrosis
519 Patholoav: qross; 11embranf's a11d fetal surface, decidual necrosis
570 f>atholoav: 11ross: 11embranes and fetal surface, decidual necrosis
(yf'S, no, unknootn)
52 Patholoay; aross; :nembr!lnes and fetal surface, meMbranes ede•atous
51 Patholoqy; aross; :nembranes and fetal surface, Insertion of
membranes
521 Patholoav: aross; ne'llbranes and fetal surface, fnsertton of
mernbranes
Porm
flAT A
ON
IrF:M
FOH~
10
NIIM
FRO"'
24
77 .PATH•1 1201
56
56
51A
518
5360 •••• VAR
25
2&
27
7B.PATH•1 1201
7Q.PATH•1 1201
BO.PATH-1 1201
57
SA
5Q
58
28
B1.PATH•1 1201
60
60
29
30
31
31
112.PATH•1 1201
113.PATH•1 1201
84.PATH•1 1201
53&5 •••• VAR
5364 •••• VAR
b1
&2
61
62
6b
527
5?.5
H
34
&1
526
522
~7
~9
15
3b
8Q.PATH•1
90.PATH•l
91.PATH•l
92.PATH•1
2201
2201
2201
2201
16
17
lR
15
16
17
19
3&
93.PATH•1 2201
20
21
37
311
39
94.PATH•1 2201
95.PATH•l 2201
96.PATH•1 2201
22
23
24
22
23
25
)9
97.PATH•1 2201
26
7.7
39
9A.PATH•1 2201
29
29
40
100.PATH•1 2201
32
33
40
9Q.PATH•1 2201
30
31
34
35
36
37
40
43
43
43
44
101.PATH•1
102.PATH•1
103.PATH•1
106.PATH•1
2201
2201
2201
;not
1~
36
37
40
OA rA HEM NAME
'fO
~5
(')
~ross
CARD
54
31
i.!.. ITEM
76.PATH•1 1201
H
H
•1.0
NumbPrs linked to nata Items on PATH-1, Placental F:Kam -
?3
24
.
Ite~
Patholoay: aross;
from e~~e of
Patholo1y: aross;
surface
P~tholoay; aross;
surface
Patholoav: ~ross;
Patholoay; aross;
Patholoav: aross;
suhchoriontc
Patholoav: aross;
vessels
Patholoav: aross;
Patholoay: aross;
Patholoay: aross;
Patholoqy; aross;
Patholoay; aross;
Cams)
Patholoav: aross;
Patholoqy; aross;
Patholoav; aross;
Patholoay; aross;
Ccm)
~e~br~nes a"d fet8l surface, shortest ~lstance
rupture to placental mar~ln (em)
~embranes and fetal surface, color of fetal
1e~branes
and fetal surface, color of fetal
1embranes and
~e~branes a"j
•e~branes and
fibrin
~e~branes and
~embranes
nembranes
1embranes
1embranes
1embranes
ani
and
and
anj
and
fetal surface, opacity of membranes
tetal surfa~e, subchorionic tlbrlns
fetal surface, description of
fetal surface, thrombosed fetal
fetal
fetal
fetal
fetal
fetal
surf~ce,
surface,
surface,
surface,
surface,
amnion nodosnm
cysts
weight (qms)
weiqht, cetaqortaed
weight; Placenta
maternal surface, intactllacerate1
maternal surface, co•pleteness
maternal surface, depressed area, total number
~eternal surfac~, depressed area, slae, lenqth
~ross; maternal surface, depressed area, slae, width
(em)
Patholoay: aross; maternal surtace, depressed area, aoparent cause
Patholoay; aross; maternal surface, hemorrnaqe, aqe
Patholoay; aross; ~eternal surface, hemorrhaqe, stze, larqest
diameter (c~)
Patholoay; aross; maternal surface, he~orrhage, size, s•allest
~lameter (en)
Patholoav: aross; maternal surface, hemorrhaqe, size, thicKness
(em)
Patholoqy; aross; ~at~rnal surface, hemorrhaqe retromembranes
shortest ~fstance fron peripheral edge hemorrna~e to placental
~arqtn (em)
Patholoay; aross; maternal surface, hemorrhaqe retroolacental
·shortest ~fstance fron oerfpheral edae hemorrha~e to placental
margfn (em)
Patholoav: aross; cut surface infarcts, total number
Patholoay; aross; cut surf~ce, Infarcts, pink/red, marqinal
Patholoav; aross; cut s"rface, Infarcts, Pink/red, not marginal
Patholoay; qross; cut surface, Infarcts, pink/red, unknown location
PAtholo~v;
F"or'll Item IIIUIIIbE"fS liniCE"d to nata Items on PATH-1,
42
44
44
104.PATH•1 2201
10S.PATH•l 2101
107.PATH•1 2201
3ft
H
41
S36Q.,,.VAR
2201
2201
220t
2?0t
2201
2201
531
45
41)
47
48
50
111.PUH•l
112,PATH•l
J l),PATH•l
115,PA'I'tt•1
114,PATH•l
117,PATH•1
51
119,PATH•i 2201
51
52
111J,PATH•1 220t
54
SJ
120. PATH•l 2201
5~
54
'i5
56
'ill
l21,PATH•1
127,PATH•1
123,PATH•l
124.PATH•1
12'i,PATH•l
126.PATI1•1
f)O
I
fROM
110.PATH•1 2201
'i9
~.....
CAkO
NtiM
44
47
411
0
10
4l
45
45
4b
•......
IrF"M
10A.PATH•1 2201
10q.PATH•l :not
44
H
H
PATA
ON
fOR"'
44
44
44
•(")
ITE"'
2201
2201
2201
2201
2201
2201
4Q
48
52
56
57
511
SIJ
bO
b:?
rn
PlacE"nt:~l
E"Ka'll -
:;ross
DA fA
JfEM NAMF.
42 P~ttholoqy; tJross; cut surf:~ce, tnfarcts, unknown color, 11arqinal
43 Patholo<ly; <1ross; cut surf:tce, tnfarcts, unknown color, not
margln/\1
44 Patholoqy; 11ross; cut surf :tee, fnfarcts, unknown color, unlcnown
location
38 PatholoC'Iy; qross: cut surf:~ce, Infarcts, vello;,lwhlte, 11arqtna1
39 Patholooy; <1ross: cut surf:tce, fnfarcts, vellow/whlte, not marqinal
41 Patholoqy; qross; cut surface, fnfarcts, vellow/wnite, unknown
location
S'H Patholoqy; <tross; cut surface, Infarcts, size
45 Patholoqy; 11ross; cut surf:.ce, Infarcts, size (em>
46 Patholoqy; 11ross; cut surface, infarcts, 'llaternal floor
47 1>atholo11y; 11ross; cut surf!lce, color
49 Patholoqy; qross; cut surt:.ce, CAlclflcllltlon
48 Patholoqy; qross; c:ut surface, consistency
S2 PRtholoqy; ctross; cut surface, Intervillous thro•bosis, total
number la:ninate::l
53 Plltholoqy; 11rnss: cut surface, tntervtllous thrombosis, number
laminate~ In marqinal sinus
'S4 P/\thololly; qross; cut surface, Intervillous throllbosls, total
nu111ber not lalllnated
~5 Plltholoov: QrO&SI cut surface, Intervillous throllbosls, nu11ber not
laminated ln marolnal sinus
~6 Patholoqy; qross; cut surface, tu111or
'i7 Piltholoqy; qrnss: cut surf:~ce, hydat:ld chsnqe
511 Patholoav: oross: cut snrf:tce, true cvsts
S9 P~ttl'loloay; ctross, exam was done with knowledge of case
61 Patholoqy; oross, special sturlies
62 Patholooy; Qross, other abnorlllalltlE"s
DEFINr:riON OF CODES PLACENTAL EXAliDT.ATION - GROSS FOR14 PATH 1
CARD 1.2012 CARD 12013
CP..RD
COLUNN
~
Card Number Code: 1 1
2. Form Number Code: 201 2-4
3· Revision Number Code: 2 - Form dated: 7/59 (Revised coding 1965)
3 - Placental l
5
.J... ,
Lt-. 1-TTIJDB Ni.ur.be:r Item 1 Nine-digit number for Patient Identification Code: As given 5· Examimtion By
15-16
Item 2
Code: See attachment "Examiners", ,::?ages?ATH 1 - 1.2 & 13
6. Ti.!ne
Item 3
Code: 0001-24cO - As giYen in hours and minutes based
on 24 h~ clock
9999 -
17-20
UDkn~vn
1· Date
Item 3
Six-digit code for:
Month (cols. 21-22) Day
(cols. 23-24) ~ (col~. 25-26) Code: As given
99 - Month, Day and/or Year Unknown
21-26
8. Desi~tion
?f Placenta
Item 5
Code: 0 - Single birth
1 - First of multiple
2 - Second of multiple
3 - Third of multiple
4 - Fourth of cultiple
27
9· I.a.be 1 ed s.t
28 Itez:1
6
Code: C - No l - Yes 9 - Unknown.
II.C.ll
PA'IH-1
DEFINITION OF CODES (cozrtinued)
?ORN PATEl
Cari 12012
Card 12013
CJ..R::J
?J::ELD
COLt.;"NN
10.
Placenta Fused
Item 7
Code: Same as in Field 9
29
u.
Anastomosis Present
Item 8
30
12.
Dil:nensi ::ms
Item 9
31-36
code for:
Largest Diameter (cols. 31-32)
Smallest Di~eter (cols. 33-34)
Code for each two columns:
01-50 - As given in ems.
97 - Multi-lobed
98 - More than one set of dimensions
99 - Unknown
Thickness (cols. 35-36)
Code: 01-95 - As given in tezrths of ems.
96 - 9.6 ems. or more
97 - Multi-lobed
98 - More than one set of dimensions
99 - Unknown
SL~-digit
She.pe
Item 10
Code: 1 - Non-partite
2 - Bipartite
3 - Tripartite
4 - Succenturiate
5 - Membranous placenta
6 - Crescent shaped
8 - Irregular shape
9 - Unknown
37
CORD
14.
Descri!ltion
Code: 0 - No description
1 - Edema
2 - Maceration
3 - Several pieces of cord sent
4 - Ua.n-ow
5 - Flat
6 - Soft
38
9 - Unknown
II.C.l2
PATH-1
DEFINITION OF CODES
(c~ntinued)
FORM PATH l
Card 12012
Card 12013
CARD
COLL.OO-T
15.
length
Item l2
C~de:
16.
39-41
999 - Unkn~wn
Sh~rtest
Placental
Item 13
C~de:
00
01-20
99
17.
Distance
Margin
- At margin
- As given in ems.
- Unkn~wn
T;rne ~f Inserti~n
Item 13
Code: 0 - Marginal.
1 - Not membranous
2 - Membran~us
9-
18.
fr~m C~rd Inserti~n t~
44
Unkn~
Number ~f Vessels
Item 14
C~de:
2 -
45
Tw~
3 - Three
8 - other
9 - Unkn~wn
19.
20.
True Y"..not
Item 15
C~de:
0 - No
1 - Yes
9 - Unknown
46
C~l~r
47
It"eml6
Code: 0 - Normal
1 - Green
2 -Yell~
3 - Purple
8 - Other
9 - Unknown
21.
Taken
Item 17
C~de:
Same as in Field 19
48
~zen Secti~n
II.C.l3
PA'l.li-1
DEFINITION OF CODES ( c~IItinued)
FORM PATH 1
Card 1.2012
Ca.r::l. 12013
CARr
COLill,lN
:?IELD
MEMBRANES AND FETAL SURFACE
22. DescrintiQn
Code: 0 - No descripti~n
1
Squamous meta~lasia
2
Amnion not available
3 Velament~s vessels
8 - other
9 - Unknown
23. Me!!l.br~nes
Como1ete
Item 19
50
24. Decidual Necr~sis
Item 20
Code: 0 - Not seen grossly
l - Presezrt, not massive
2 - Presezrt, massive
8 - other
51
9 - Unknown
25. Membranes Sdema.tous
Item 21
Code: 0 - Uo
l - Yes
2 - Possibly
9 - Unknown
52
26.
Inserti~n of M~ranes
Item 22
Code: l - Marginal
2 - Circumma.rginate
3 - Combination of codes
4 - Circumvallate
5 Combination of c~des
6 - Combination of c~des
7 Combination of codes
9 Unknown
53
-
27. l and 2
land 4
2 and 4
1, 2 and 4
Sh~rtest Distance From Edge of Ru-oture to
Placental ~!argin
Item 23
Code: 00 - At margin
'IT - ~~Iem.branes not ru]?tured
99 -
54-55 Unkn~;,;·n
II.C.l4 PA'IH-1
"GEFI!UTION OF CODES (c:;,ntinued) PATH 1
Card 2.2012
FORM
Card 12013
CJl.PJ)
COLlJ1-lN
?BLD 28. ~f Fetal Surface
Item 24
Code: 1 - Blue-gray
2 - Green
C~1~r
3 -
4 -
C~mbinati~n ~f
codes 1 and 2
Br~'WUish-yell~w
1 and 4
of codes 2 and 4
7 - Combination of codes l, 2 and 4
8 - Other
9 - UnknO"WU
6 -
C~mbination
29. Ooacity ~f Membranes
Item 25
Code: 0 - Not O!laque
1 - Q:9aque 2 - Partially O!laque 9 - UnknO"WU 57
30. Fibrin
Item 26
Code: 0 - Hot seen
Present, not massive 1
2 - Present, massive 58
Sub-Chori~nic
9 - UilknO"WU 31. Descrinti~n ~f Sub-Ch~ri~nic
Item 27
C~de: 0
1
2
3
9
32. 33. Fibrin
59
- No sub-chorionic fibrin - Patchy - Diffuse - Combination ~f c~des 1 and 2 -Unknow"D. Thrombosed
Item 28
Code: 0 1 9 -
60
Fetal Vessels
Not seen
Present Unkno"WU Amnion Nodosum
!tem 29
C~de:
Same as in Field 32
61
II.C.lS PNIH-1
DEFINITION OF CODES
(c~ntinued)
FORM PATH :.
Car:i l2Cl2 Car:i l2Cl3 O.ED
COLU:·I!T
34.
Cysts
Item 30 C~de:
0 - Not seen l-7 - As given 8 - 8 ~r more, numer~us 9 - Unknown 62
35·
Weisz:ht
Item 31 C~de:
0001-2000
As given in gms • 9999 - Unknown 63-66
Blank
67-72
37·
*
p1 acenta Number
C::::~de: Instituti::::~n ideiitificati::::~n* as giYen
8 Blanks - None rep~rted
ftny c~mbinati::::~n ::::~f
blanks permitted in
alpha and numeric codes "'ith
c::::~ls.
76-80.
II.C.l6
73-80
PA'm-1
DEFniiTION OF CODES (c~trtinued) FORM PATH 1
Card 22012
Card 22013
CARD
COLUMN
1. Card Number
Code: 2
2. Basic Data
Code: Same as in
1
c~ls.
2-14
2-14 of card 1
MATERNAL SURFACE
3· Surface
Item 33
Code: 1 - Intact
2 - Lacerated 9 - Unknown 15
4. Comoleteness
Item 24
Code: 1 - Complete
16
2 -
Inc~mplete 9 - Unknown 5. De"Oressed Area
17-22
Items 35-37
Six-digit code for: Total Number (col. 17) Code: 0 - None 1- One 2 - Two or more
3 - Present,number unknown (ReY. "3" onJ.y)
9 - Unknown Size: Length (c~ls. 18-19) Size: Width (cols. 20-21) Code for each two c~lumns: QQ - Not a"'"'licable
01-~
- As
given
A-o"Oar~&-c2~~~1. 22)
Code: 0
1
2
3
- Not applicable - Hemorrhage - Atrophy or In:farct - Combination of c~des
4 - other (Rev. 3 only) 5 - Combination of c~des
7 - Combination of c~des
1 and 2 1 and 4 2 and 4 1, 2 and
4
9 - Unknown NOTE: O's in entire field= no depressed area
II.C.l7 Reproduced at the National Archives
PA'IH-1
FORH P.o..TH l
Card 22012
Card 22013
DEFINITION OF CODES (continued) CARD
COLUMN
6. 23-33
Hemorrhab1:e
Items 38-40
Eleven-digit code for:
~ (col. 23) Code: 0 - None '1- Recent, elastic
2
Old, firm
3 - Combination of codes 1 and 2
8 - Hemorrhage present but age uneyecified
9 - Unknown
Size: Largest Diameter (cols. 24-25) Size: SmallestDiameter (cols. 26-27) Size: Thickness
(cols. 28-29) Code for each two columns: 00 - Not applicable 01-98 - As given 99 - Unknown
Shortest Distance from Peri-oheral Edge of Hemorrhage
to Placental Margin: Retro-ola.cental (cols. 30-31)
Retr~embranous (cols. 32-33)
00 - Not applicable
TI - Less than 0. 5 ems.
98 - Hemorrhage present but distance llilkn~
99 NOI'E:
Uuknown
0' s in entire field
= no
hemorrhage present
CUT SURFACE
7· Infarcts
Items 43-45 Twelve-digit code for: T~al Number (cols. 34-35) Code: 00 - None 01-96 - As given
97 - 97 or more
98·- Too numerous to count
99 -
34-45 Unknown
Pink-Red: Marginal
(co~- 36) Pink-Red: Not ~.fa.rginal (col. 37) II.C.l8 Reproduced at the National Archives
PA'IH-1
DEFINITION OF CODES (c~ntinued)
FORM PATH 1
FELD
Card 22012 C;ord 22013 CARD
COLill-lN 7·
Infarcts (c~ntinued) Yell~wish-White: ~erginal
(c~l. 38) Yell~wish-White: N~ ~ergina1 (c~l. 39) C~de f~r
0 -
each
34-45
c~lumn: N~ne
1-7 - As given
8 - 8 ~r more, t~o numer~s to c~unt
9 - Unknown
Pink-Red: Unknown l~cati~n
(c~1. 4o)
Yell~,•-'Wnite: Unkn~ 2.~cati~n
(c~l. 41)
Unknown Co1~r: ~~rgina1
(c~l. 42)
Unknown C~1~r: N~ ~~rgina1
(c~l. 43)
Un_~own C~lor: Unknown location (c~1. 44)
Code for each c~1umn:
0-
N~e
1-7 - As given
8 - 8 or more
9 - Unknown
Size (col. 45)
- - 0- Not applicable
1 -All infarcts less than 3 ems.
2 - At least one infarct measures
3 or more ems.
9 - Unknown
8. l-~terna.l.
FJ o~r Infarcts
Item 46
Code: 0 - N~ seen
1 - Present
9 - Unknown
46
9· Co1~r
47
Item 47
Code: 0 - Normal
1 - Unusually light
2 - Unusually dark
3 - Combination of
8 - other
9 - Unknown
10. c~des
1 and 2
Consistency
Item 48
Code: 1 - Firm
2 - Sp~ngy
3 4 -
48
Combinati~n ~f ~~des
S~:ft
1 and 2
9 - Unknown
II.C.l9 Reproduced at the National Archives
PAm-1
DEFINITION OF CODES (continued)
FOfu\1 PATE 1
Card 22012
Card 22013
CARD
COL\.J}ffi'
u. Ca1cificati:Jn Item 48 Code: 0 - None 1 - Maternal surface only
2 - Throughout
9 - Unknown
12. Interril1~s Thrombosis
Items 50-53
Six-digit code for:
~ (co1s. 50-51) Code:
00 - None 01-56 - As given
97 - 97 or more
98 - Too numerous to count
99 - Unknown
T:lta1 thlmber Ieminated
(col.
Number Laminated in Marginal Sinus
(col.
Total Number Not Laminated
(col.
Number Not Laminated in Mar!Zinal Sinus (col.
C:lde for each column:
0 - None
1-7 - As given
8 - 8 or more, too numerous to count
9 - Unknown
l3. Tumor
Item 54
14. Hydatid Change
Item 55
15.
~· ~sts
Code:
16. 52)
53)
54)
55)
57
Same as in Field 12, col. 52
Gross Examination Done With Kn=wle4ge That
Item 58
Code: 1 - Clinical outcome normal
2 - Clinical outcome abnormal
3 - No knowledge of case
9 - Unknovn
II.C.20 Reproduced at the National Archives
50-55
59
PA'!li-1
DEFINITION OF CCDES (continued) FOF.M PATH l
Ca!"d 220:..2
Card 22013
CARD
COLUMN
17. Special Studies
Item 59
Two-digit code for:
Photography', V'irologz or Histochemistry (col. 60)
Code: 0 - None
1 - Photography only
2 - Virology only
4 - Histochemistry
7 - Combination of codes 1, 2 and 4
60-61
9 - Unknown
~(col. 61)
Code: 0 - None
1 - Bacterial culture
2 - Other than bacterial culture
9 - Unknown
18. Other Abnormalities
Item 6o
Code: 0 - No
1 -Yes 9
62
-Unknown 19. Designation of Placenta
Item 5
Code: 0 - Single Bi.-th
1 - First of Multiple 2 - Second of Multiple 3 - Third of Multiple 4 - Fourth of Multiple 63
20. Blank
64-72
21. Placenta Number
Code: Institution identification* as given 8 Blanks - None reported 73-80
* Any combination of alpha and numeric codes ~ith blanks
pe~tted in cols. 76-80.
II.C.21 PAm-1
PLA~L
EXAMINATION - GROSS
EXAMINERS
05 - Boston
01
02
03
04
05
06
07
08
09
10
ll
l2
13
14
15
16
17
18
19
20
21
22
Benirschke
Driscoll
J.K.
Potter
Craig
Szul.ma.n
Bradford
Leoindas
Cury or Kury
Favara
Aires
Alvardo
McCoombs
Mechanic
Gibson
Santos
Amicic
Paci
Raslavicus
Deligiosi
Saber
rNb.yte
23 Laga.
24 Ma.lou.f
25 Hedley
99 Unknown
10 - Buffalo
01
02
03
04
05
o6
07
08
09
10
99
0' Sullivan
Aq_uino
Froehlich
Legnami
Lehoczky
Ma.na.gle
Aterman
Harrod
Abaci
Darwish
Unknown
15 - Charity
01 Johnson
02 Burch
03 Gilmer
04 Foley
05 Rosal
06 Elliott
01 Medawa.r
·08 Beck
09 Melton
10 Meek
99 Unknown
31 - Columbia
01
02
03
04
05
99
Blanc
Kaufman
Goetz
Navarro
Richard
Unknown
37 - Johns Hopkins
01 Gruenwald
02 Brown
03 Lane
04 Kramer
05 Hannibal
o6 Nicastri
01 Linthicum
08 Beitnott
09 Bloodwell
10 McCall
11 Lee
l2 Clowry
13 Pusch
14 Esterly
15 Hutchins
1.6 Ebert
17 Haghighi
18 Patterson
19 Haller
20 Benson
21 Porro
22 Berman
II.C.22
PA'IH-1
PLACENTAL EXAMINATION - GROSS
EXAMINERS
37 - Johns Honk:.ns
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
h.l
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
99
Frederick
Bamby
Simonsen
Rieumont
Bransf'ord
WL
MacLeod
Cornell
Caplan
Jacobs
Wasserman
O'Quinn
Hingson
Lewis
Henjyoji
Zerins
Taylor
Brazendale
Rogers
Goldman
Russo
Wasnich
Wheeler
Mancini
Pelham
Laubscher
Singer
Curtin
Gray
Wilson
Vitsky
Leiby
Siegal
WDZ
Ziererink
Tole
Brammer
Abraham
Houghtlaling
Johnson
Hall
Addma.n
te.vis
Shelley
Elliot-c
Baens
Woodward
Unknown
(cont.)
45 - Virginia
01 Belter
02 Richart
03 Martin
04 Calle
05 Bates
o6 Davis
07 Nakoneczna
08 Ishizaki
09 Friedrick
99 Un.kno•..m
50 - Minnesota
01 Burke
02 Swa.llen
03 Woolf'rey
04 Goodlin
99 Unknown
55 - New York Medical
01 diBlasi
Cempo
Kim
03
o4 Sedlis
05 Sonnenblick
o6 Mabairas
07 Stone
08 Gugliucci
09 Murphy
10 Asima.kopulos
11 Saphier
12 Derry
13 Kapusta
14 Smith
15 Fabricant
16 Brenner
17 Caturani
18 Seigal
19 Vansom
20 Olivo
21 Yatvin
22 Schwartz
23 Wasserwald
2h. Aneckstei!l
25 Ortiz
26 Dacosta
02
II.C.23
(cont.)
PA'IH-1
P!ACEN'I!AL EXAMnTATION - GROSS
EXAMTilERS (cont.)
55 - New Y:Jrk .Medical (cant.)
66 - Pennsylvania (cont.)
27
28
29
30
31
32
33
34
35
36
99
60 - Oregon
21
22
23
24
25
26
27
28
29
30
31
32
99
01 Fujikura
71 - Providence
02
03
o4
05
o6
07
08
99
09
10
66
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
Kandemir
Breyan
Clemendor
Pineda
Cal.noy
Lim
McCartin
Vasq_uez
Pal.!ller
Lef:'(owi ~z
Unknown
Emig
Berro~h
Philp
Gourley
Welllngs
P'lropst
Evans
Unknown
Waterman
Napier
- Penns.zlvania
Ziel
Scarano
Sharpe
Lerner
Baker
Chatten
Knauer
Gonzalez
Muniz
Schiller
Hausman
Weidmann
Schultze
Frederick
Pendleton
Lane
Beatty
Seidel
19 Vakil
zcr tmmrao
Prompiti
Francis
Ba.roff
Lipkin
Sumerson
Stanitski
Longo
Crane
Decker
Olen
sz
E.D.E.
Unknown
01 Song
02
03
o4
05
o6
07
99
Anderson
Grace
Freeman
Mald
Robinson
Fethiere
Unknown
82 - Tennessee
01 Johnson
02
Greer
03 Pitzer
04 Brown
05 Crocher
o6
Bowers
07 Fuste
o8
C.A .c.
09 T.A.B.
10 A.B.
l l Manzano
l2 Blumenfeld
13
14
15
16
17
18
19
II.C.24
Smith
Ainsworth
Wise
ThreL'-<eld
RHA
Bushaw (see
Sainz
?lJ.\
I
P.MH-1
•
\:! .l. N 3 ~H:I id
I
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P.A!l'H-1 - 16
II.C.25
PATH-1
PLACENTAL EXAMINATION - GROSS FOIN PATII-1 t:T&P..
*' 11
WtJ~
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39
140 1 43 1
44
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PLACENTAL EXAMINATION-GROSS
(For Form PATH-1, Dated 7-59)
PURPOSE. The purpose of this examination is to
provide precise and detailed information about
the gross appearance of the placenta and how
it may relate to the outcome of the pregnancy
. for both mother and infant. Report the infor
mation on PATH-I, Placental Examination Gross.
ORDER OF EXAMINATION. For the sake of con
venience and thoroughness, the order of the
examination is to conform in so far as possible
with the order of items as they appear oo the
form.
EXAMINER'S LACK OF BIAS. In so far as pos
sible, the examiner should have no kuowledge
of the course or outccme of the pregnancy
until this form has been completed.
WHEN TO USE THIS FORM. This form is to be
used in every case in which the crown-nDDp
length is 16.5 centimeters or more (gestational
age 20 weeks or more), and. in those cases in
which the placenta is intact when the fetus is
less than 16.5 centimeters crown-nDDp.
DESCRIPTION OF ABNORMALITIES. All abnor
malities are to be described in the space pro
vided at the bottom of the form. This includes
those abaormalities which are not specifically
mentioned in the form. If the space at the
bottom of the form is not sufficient, additional
pages may be added. Wherever possible, in
clude the item number with the description of
the abaormality.
METHODS OP PREPARING SECTIONS. At least
three sections ar-e to be prepared: cord,
membrane roll, and placenta. In cases of
twins, a section of the dividing membranes
should also be prepared. In addition, sections
of all significant gross abaormalities are to be
prepared.
SECTION OF DIVIDING MEMBRANE OF TWINS.
In fused placentas the first step after in
spection and measuring of the length of the
cord, etc., should be to remove a square of
membranes from the area which divides the
In other words, the
two aauu0111c sacs.
dividing membranes are identified and a section
is cut through them. This section of mem
branes is then rolled by means of forceps and
the roll is placed in fixative. After 24 hows,
it is trimmed so that a jelly-roll-like structure
is obtained for histologic examination.
SECJ'IOH OF UMBILICAL CORD. At the end of
the gross examination of the umbilical· cord,
the ccxd is cut at a point two centimeters
from the fetal surface and a section of the
middle portion of the cord is placed in fixative .
This segment should be approximately three
to four centimeters in length and after proper
fixation, a section should be trimmed from its
center.
PREPARATION OF MEMBRANE ROLL. After
inspection of the membranes, a segment is cut
out measuring approximately ·ten centimeters
in length and five centimeters in width, start
ing at the point of rupture and proceding to
wards the margin of the placenta and including
a very small piece of marginal placenta. Care
must be taken that the amnion is not stripped
off in this procedure. This section of mem
branes is then rolled by means of forceps aud
the roll is placed in fixative. After 24 hours,
it is trimmed so that a jelly-roll-like structure
is obtained for histologic examination.
SECTION OF PUCENTA. After complete section
ing aud inspection of the cut surfaces of the
placenta, select a representative block of
placental tissue. Such a block is preferably
three to four centimeters wide, spanning the
entire thickness of the placenta aud including
the fetal surface with some large fetal blood
vessels. It must be handled carefully lest it
disrupt in the center. It should be chosen
from the central portions of the placenta, some
three or four centimeters away from the in
sertion of the cord, and it should be placed in
fixative immediately. Abnormal areas, such
as tumors, intervillous thromboses, and
occasional infarcts, should be sampled as
indicated. It is not deemed advisable to section
all infarcts. However, it is suggested that
cysts aud intervillous thromboses and any
other unusual structures be sampled fcx his
tologic observation. The choice of fixative
is left to the individual institution.
1.._1, Patient ldentlflcatl011. As a minimum, enter
the patient's name by addressograph ex other
method.
lte. 2, Gross Exa111inatl• By.
status of examiner.
,.._ 3, Ti.. and Date.
of the examination.
Enter name and
Enter the time and date
January 1960
II.C.27
P.Am-1
PLACENTAL EXAMINATION- GROSS (Coa't)
PATH-I
7-59
Item 4, Multiple Births. In cases of multiple birtha,
35 millimeter Kodachrome photographs of the
placenta must be submitted with the prococol.
Each fetus is to be designated A, B, etc.,
with regard to order of birth and a separate
form is to be used for each fetus evea if the
placentas are fused. In cases of fuaed placen•
tas, all entries after Item 13 refer to that
portion of the placenta con t&iniag tbe fetal
circulatory district of the fetus whose desig
nation appears on the form. If the farm is
being used for a single birth, leave Iteaa S-8
blank.
lte111 5, !)eslgnatlon of Placnta DescriMci • tills
F-. If the multiple binh has two _.bers
enter the designatioo of the placenta of the
twin described on this form. If the desipatioaa
have not as yet been assigned on the basis of
binh order, they are to be arbitrarily usigued
at this time. If this multiple birth has mare
than two members, check box • other •ltiple
binhs• and enter in space at the bottaaa of the
form the number of fetuses and their desig
nation.
Item 6, Labeled
at
Dellwry. Self-explautcry.
Item 7, Placentas Fused. Enter •yes• or •r110• in
this space. Fill out a separate form for each
fetus in either case.
lte111 8, If Fused Placentas, Is Anast-..ls Pte
sent. In cases of fused placentas, the safest
way to identify anastomoses is by injectioo
of a colored medium into the placenta. Isolate
areas of JI'Obable anastomoses anddisaectooe
small surface vessel which leads into this
district. Then isolate this vessel, iuert a
cannula with a ball tip, tying a small tie be
bind this ball tip and inject either air or
}X'eferably a colored dye. White or greea dyes
(e.g., a light green saline solutioo) provide
better contrast than blue or red dyes ud are
mare }X'actical than the use of plastic ia
jectioo materials. Large anastomoses -y be
identified readily by moving the po.sibly
I iquid blood in this large vessel frae oae
placental district to the other. Check appo
}X'iate box and describe anast01110ees ia tbe
space provided at the bott9m of the fan~o Ia
dicate whether anastomoses are lll'ta'y to
anery, vein to vein, or artery to veia. Note
size of anastomoses, etc.
lte111 9, Dl-nslons. The thickness is meuurecl
at the center of the placental tiss. by pierc-
ing it with a knitting needle on which centi
meter marks have been inscribed.
lte. 10, Shape. Check aP}X'opriate box. If shape
is other than round or oval, describe in Item
61.
lte.a 11, Card. This section refers to the exami
natioa of the umbilical cord. If abnormalities
are present other than those specified, de
scribe them in Item 61.
lt.. 12, Length of Cord. Measure and enter the
length of the cord left on the placenta plus
any loose pieces.
The pediatrician will
measure the length of the cord left on the
baby so that a total length may eventually be
obtained.
lte.a 13, Shortest Distance fr. . Card Insertion to
Placental Margin. Reccrd this distance in
ceutimeters. Check
box with regard to
type of insenioo. I a memlxanous insenioa
is present, describe the course and integrity
of the large fetal vessels from the insenion
of the cord aloog the membranes onto the
placenta.
roper
lt.. 14, Nu111ber of Vessels.
Self-explautory.
lt.. 15, True Knot In Cord. Check aP}X'O}X'iate
box. In the presence of true lmots, this seg
meat of the umbilical cord should be fixed in
toto and sectioas should be placed at the ends
of the knot and through its center to observe
possible thrombosis in some of the blood
vessels.
lt.. 16, Color of Cord. Check &PJI'opriate box.
If color is abnormal, describe in Item 61. In
clude some impression as to possible etiology
of abnormal coloration.
lte. 17, Froun Section Taken. Check appropriate
box.
lt.. 18, M..n•• and Fetal Surfaces. If ab
normalities are present other than those
specified, describe them in Item 61. This is
to be especially emphasized in the case of
spaatueoas hemorrhage of the fetal surface.
lt.. 19, Me.ln•s Ca.plete.
Self-explanatory.
lt..20, Dechl•l Necrosis. This refers to changes
in the decidua capaularis.
January 1960
PATH-1
PATH-I
7-59
PLACENTAL EXAMINATION -GROSS (Con't)
Item 21, Membranes Edematous.
Self-e.xplanatcry.
Item 22, Insertion of Membranes. If the insertion
is partial, then check two boxes to describe
it properly and note in the space at the bottom
of the form the proportion of each type of in
sertion, (e.g., in case of partial circumvallate
insertion, check circumvallate and marginal
and then note at the bottom of the· form the
propcrtion of the periphery of the placenta
occupied by each type of insertion).
Jr.'. 23, Shortest Distance from Edge
Gf Rupture
to Placental Margin. If the rupture is at the
margin cr through the body of the placenta,
enter •o• and describe in Item 61.
lte• 24 1 Color Gf tho Fetal Surface. Self-explana
tcry.
Item 25 1 Opacity Gf Membranes. Self-explanatory.
ltot. 261 Subchorionic Fibrin. This entry refers to
the quantity of fibrin present.
·
lte• 271 This entry refers to the distribution of
fibrin present.
Ito• 281 Thrombosed Fetal Vessels. This does·
not include clots which famed after birth. If
thrombosed vessels are present, note in Item
61, the type of vessel, 1ts size and the pre
~ence cr absence of degenerative changes in
its walls. Also describe the thrombus and
give an estimate of its age.
Ito• 29 1 Amnion Nodosum. If present, include in
Item 61 a general description as to size, num
ber and colcr of the granul.es.
Ito• 301 Cysts. If present, describe in Item 61.
Note the number, size, locatiOD, and type, of
cootents. Especially note the presence cr
absence of bemcrrhage into the cyst.
Ito• 31 1 Weight Gf Entire Placenta Loss Cord,
Me..bra... 1 ancl Largo Clots.
Reccrd in
grams. In cases of fused twin placentas the
placenta is to be cut aloog the approximate
cleavage plane of fetal circulatory districts.
The weight entered is to be that of the fetus
whose designation appears on this form.
Item 32 1 MatomGI Surface. If abncrmalities are
present other than those specified, describe
them in Item 61.
•
Item 33 and 34, Surface. Self-explanatcry.
Item 35 1 Depressed area. If •none• is checked,
leave items 36 and 37 blank.
Item 36 1 If Pr..ont. State largest diameter and
smallest diameter.
Item 371 Ap...,.atly Caused By. If cause is known
and is not hemcrrhage, atrophy, cr infarct,
check ·~ cr •unknown• cause and give
cause in a note in Item 61.
It•• 38 1 tto.orrhago. If •none• is checked fer
Item 38, then Items 39 and 40 are to be left
blank. If mae than one hemcrrhage of signi
ficant size is present, then the largest one is
to be described in Items 38 - 40 and similar
information is to be provided for others of
significance in Item 61.
Item 391 Size. Self-explanatcry.
Ito• 40, Shortest Distance from Peripheral Edge
Gf Ho~M~Thage to Placental Margin. Measure
the shortest distance from the edge of the
hemorrhage to the placental margin and check
either cr both boxes as applicable.
Ito• 41 1 Cut s-faco. If abnormalities are present
other than those specified, describe them in
Item 61.
Ito• 42, Infarcts. Give number of infarcts according
to colcr, in Items 43 and 44 if present. If
none are present, write •o• in both blanks in
Items 43 and 44. Also check box labeled
•not applicable• in Item 45.
Ito• 43, Plnlc-Rod Infarcts. Self-explanatcry .
•
Ito• 441 Yell--White Infarcts.
Self-explanatcry.
Item 45 1 Size .f lllfarcts. All infarcts more than 3
centimeters in largest diameter must be de
scribed in Item 61. The distribution of these
infarcts should be noted and may be entered
in a sketch of the placenta.
Ito• 461 Maternal Floor Infarcts. This refers to
areas where the maternal surface is yellowish,
very firm, and thickened. On section of these
areas, the major portico of the villous tissue
is normal, but the flocr is apparently infarcted.
If such an infarct is present, describe it in
the space provided at the bottom of the fcrm
with regard to its size and location. The
January 1960
PA'IH-1 PLACENTAL EXAMINATION -GROSS
(C~'t)
PATH-1
7-S9
fis~:~ures which normally divide the ••ternal•
cotyledon& are often absent in this coadition.
If the fissures are absent, this sbould be
noted in the description.
Item 56, Tr.ue Cysts (In Substance). Enter number
present. If none, write •o". Describe each
cyst in Item 61 with regard to size, location
and type of contents. Especially note pre
sence or absence of hemorrhage into the cyst. ,
Item 47, Color. This refers to the color of the cut
surface.
Item 48, Consistency. Self-explanatory.
Item 49, Intervillous Thrombosis. If none are ob
served, write •o• in Items SO- S3.
Item 50, Total Number Laminated.
lte. 57, Patient Identification. As a minimum,
enter the patient's name by addressograph or '
other method.
1.._ 58, Gross Examination was Done with the
Knowledge That: Self-explanatory.
Self-explana
tory.
Item 59, Special Studies. Describe any studies
other than those choices specified on the
Item 51, Number Laminated in Mlll'li•l SiRus.
farm. •Photography" does not refer to routine
photography of multiple birth placentas.
Self-explanatory.
Item 52, Total Number not Laminatecl. Self-expla
natory.
Item 60, Pr.sence of Other Abnormalities. Check
appropriate box with regard to the presence
or absence of abnormalities other than those
specifically mentioned in the form.
Item 53, Number not Laminated In Mlutl•l Shws.
Self-explanatory.
Item 54, Tumor. If present, describe in ltea 61 with
regard to type, size, location, shape, color,
Item 61, Description of Abnormalities.
In this
space, all those abnormalities previously noted
and all those abnormalities not specifically
noted in the form are to be described. When
ever possible include the item number with
tbe description of the abnormality.
consistency, etc.
If preaeat, dacribe in
Item 61 with regard to appearance aad extent.
Item 55, Hydatid Change.
January 1960
II.C.30
PA'IH-1
PATH-2
Placental Examination - Microscopic
Form PATH-2 provided precise, detailed information about the microscopic
appearance of the placenta and how the placenta might relate to the outcome of
the pregnancy for both mother and infant. The form was implemented into the
study in November 1959; it was not revised. Data from PATH-2 were coded onto
card 1202 of the master file (Table PATH-2.1).
TABLE PATH-2.1 Cards and Data Records by Revision for Form PATH-2
CARD
NUMBER
CARD NAME
PATH-2: Cord, Membranes, Decidua,
Terminal VIlli
REV.
NO.
NUMBER
RECORDS
1202
2
49,799
49,799
total for form
II.C.31
49,799
PA'IH-2 II.C.32
PA'IH-2
Data Items Referencing Form PATH•2,
DATil
..
H
H
(')
w
w
~
I
N
Plac~ntal
F.xam - M1cros.
TtF.M
ITE114
JN
TO
F"JRM
110 •••••••
111 •••••••
132.PATH•2
1H.PATH•2
1l4.PAfH•2
115.PATH•2
136.PATH•2
1l7.PATH•2
llB.PATH-2
2
3
3
3
4
5
8
1H.PATH•2
C~Rn
NUM
FROM
1102
1202
1
6
1202
1202
15
17
llJ
21
23
170'2
1202
1?.02
1202
24
1207
25
9
1?.02
26
140.PATH-2
10
1?02
27
14l.PAT"f•2
142.PATH•2
143.PATII•2
144.PATII•?.
11
12
15
16
1202
1202
1202
29
1?.0?
31
145.PATH•2
17
1?.02
3?
146.PATH•2
lR
1202
31
147.PATH•2
20
120?.
3i
148.PATH•2
21
1202
15
149.PATH•2
22
1?0?
31>
1!i0.PATH·2
23
1?0'2
37
151~PAT1i•2
24
1?.02
3A
1"i2.PATH•2
25
1202
3Q
2R
]0
1'\3.P~TH•2
27
1'202
154.PATH·1.
155.PATH•2
1R
2Q
1207
1202
40
4?.
44
1';6.PAfH•?.
157.PATH•2
1!i8.PAfH•2
l2
3l
34
1202
1202
1?.02
45
46
47
TO
DAtA JfEM NAMF.
5 Car1 numbPr (SeQuence, forn typP, form nu~oer, revision number)
t4 NlNOB casP number
16 Patholoayr ~icroscooic, ex~mination by
18 Patholoayr microscoPic, 1ate f~o)
'20 PatholoOYJ microscooic, 1ate (1ay)
22 P~tholoay; ~icroscooic, oate (yr)
?.3 PatholoQyr mtcroscoolc, jesl1natton of Placenta, plurality
24 Patholoav: microscopic, a~nton available for examination
?.5 Patholoay; microscopic; corrt, neutrophilic tnflltratlon, umbilical
vein
?.& PatholoayJ microscoolc; corrt, neutrophilic Infiltration, umbilical
artery
?.7 Patho\oay; microscopic; cord, neutrophilic tnflltratlon, cor1
substance
28 PatholoayJ microscopic; cord, thrombosis of vessels
29 PatholoQYJ microscopic; cord, nu~ber of u~bllical arteries
30 Patho\oay; microscopic; menhranes, epttheliue of amnion, necrosis
31 Patholoov: microscoPic; ~e~branes, epithelium of amnion, squamous
metaolasta
32 P~tholoay; microscopic; menhranes, epithelium of amnion, amnion
no1osum
33 PatholoQy; m1rroscoo1c; ~enbranes, epltheliu' of smnton, bacterial
colon iPs
34 ~atholoovr microscoolc; nenbranes, neutroohllfc Infiltration,
nembrane roll, amnton
15 P~tholoay; mlcroscooic: nenhranes, neutroontlic infiltration,
membrane roll, chorion
1& Patholoavr microscoPic; nenhranes, neutroohlllc Infiltration,
Placental surtacP, amnton
17 Patholoay; microscopic; ~enbranes, neutrophilic 1nf1ltrat1on,
olacPntal surface, chJrton
3Y PAtholoQv; mirroscopic; nenhranes, neutroPhilic infiltration, fetal
surface vessels
19 Patholoav: microscopic; ~enbranes, fetal surface vascular changes,
other
41 Patholoay: microscopic: nenbranes, macrophsqes in amnion or chorion
43 PatholoQy: microscopic; ne~hranes, macrophaqes in decidua
44 Patholoov: microscoolc; menbranes, class. of dividing •e~branes o•
twfn placentas
45 Patholoay; microscopic: de=idual vessels, thro•bosis
46 PatholoQVJ microscootc; dectdual vessels, fibrinoid
47 Patholoav: mir.roscooic; de=ldual vessels, atherome
natd Items RPferenring form PATH-2, PlacPntal
In:ro~
]OJ
TD
F'JRI4
CARO
Nlf14
FR0"4
411
H
5fl
5t
1'i9.PATH-?
160.PATI-I-2
161.PATI-I•2
1f;2.PIITI-J•?
40
1207
1202
1202
1202
1fi3.PIITI-f-7
41
1?02
57
1fi4.PATH•7
42
1?.0?
51
165.PATH-?.
16b.PATH•2
44
45
1202
11.02
54
55
lfi7.PAT1t•2
46
1202
56
tU.PATH•?
48
1202
57
1-t
1-t
169.PATH•7
49
1202
511
(')
170.PATH•?.
171.PATH•2
172.PIITH•7
17l.PATH•2
174 • PAT If • 7
17S.PIITH•2
17&.PATH•2
50
52
5'l
54
55
56
57
l'-0'2
1'202
120?.
1202
120?.
1?0?.
1202
171.PATH•2
178.PATH-2
58
61-62
179.PIITH•2
63
1AO.~ATH-2
•w
~
-
~tcros.
I f I'M
l>I\TA
.
~xam
3,;
37
38
53
&I)
61
&?.
TO
DA fA
18 Patholoay: mtcroscoptc:
microscopic;
50 Patholoav: microscopic;
51 Patholo~y; microscoPic;
marqln
52 Patholoov: microscopic;
caPsularts
53 P~tholooy; microscopic;
basalis
54 Patholoovl Microscopic;
55 Patholoav: •icroscoolc;
caosularts
56 P~tholoayr •tcroscootc:
basalis
57 Patholoovr •tcroscootc:
deposition
58 Patholoavl mtcroscoptc;
cnanoe
'i9 Patholoav: •tcroscoptc:
60 P~thoJo1v: mtcroscoplc;
61 Patholoqv: mtcroscoplcJ
62 Patholoqy: microscootc;
49 P~tholoay;
64
63 P~tholoav: mi~roscoplc;
64 Patholoav: mtcroscootc:
6';
~~
1?.02
1202
66
66
b7
fi8
1202
1202
{)Q
64
69
70
1'll.PATH•7
65
1202
7t
lRl.PI\TH-2
66
67
17.0?.
1202
17.02
17
1RJ.PATH·7
63
70
Patholoav: microscopic;
circulation
Patholoav: mtcroscootc;
Patholoav: micrnscoplc;
villous Infarction
P~tholoqv: microscooic:
Patholoqv: mi~roscooic;
trF.M
NAME
necrosis, mar~ln
jpcfdual necrosis, capsularls
decfd~al necrosis, basalts
decidua, neutroPhilic infiltration at
jectd~al
neutrophilic infiltration ln
dectd~a,
jecldua, neutrophilic infiltration In
decf~ua, ly•phocytlc Infiltration at •argln
decidua, Jy•phocytlc Infiltration in
jecJjua, Jy•phocytlc lnflltratlon ln
~ecldua,
.cytotrophoblast of colu•ns, flbrln
dectdua, cytotrophoblast of columns, cystic
decidua,
terminal
terminal
terminal
terminal
tPrmin~l
termi~al
syncytium, nuclear clumptnq
villi, L~~qnans' laver
villi, Hofbauer cells
villi, stro~al fibrosis
villi, patholoqtcal edema
villi, mtcro Infarcts
villi, nucleated RRC ln fetal
terminal villi, melanin
intervillous space, thrombi
an~
adjacent
intervillous space, marqinal sinus thro•bl
intervillous space, slcklfna: maternal
hlOO~
~
I
N
1A4•••••••
73
74
micros~opic; intPrvillous space, apparent\maturitv of
Placenta
72 Patholoav: microscopic: exam 1one wlth kno~le~~e of case
73 P~tholo~v: microscoPic; otner ~bnormalities present
71 Patholoqy:
RO
~lank
510 PatholoclV; cord, arteries, number
'i361l •••• VAR
'il70 •••• VAR
5J11 •••• VAR
12
27
27
532
534
514 Patholoav: m!croscooic: me1branes, macrophaqes tn amnion or chorion
'i372 •••• VAR
537J •••• VAR
28
5.)';
536 Patholo'lv: microscoolc;
5.)0
513 Patholoqy; microscooic:
(yes, no,
537
~e1branes,
macrophaqes In amnion or chorion
~nknown)
nPnbranPs, macrophaqes tn decl1ua
537 Patholoav: microscopic: nenbranes, macrophaqes In decidua <ves, no,
unknown)
Oata
Ite~s
R~ferencinq
~xam
-
~tcros.
Ttr.M
DATA
ITE'4
JN
TO
F'JIHC
5374 •••• VAI?
Form PATH•2, Plecental
20
CARD
NIIM
FRUI4
·ro
OAfA ItEM NAMr;:
53R
518
microscoolc: ~enbrAnes, neutroonlllc lnflltratlon,
roll, amnion
PAthoJoqy; microscoolc: ~enbr~nes, neutroonlllc lnflltratlon,
me~brane roll, amnion (yes, no, unkno-n)
Patholoqy; microscopic: neabranes, neutropnlllc lnflltratlon,
Placental surface, amnJon
P~tholooy; microscopic; ~e•branes, neutroonlllc lnflltratlon,
Placental surface, a~~fon (yes, no, unknown)
PAtholooy: microscoolc; menbr~nes, neutroonlllc lnflltratlon,
me~brane roll, chorlo~
Patholooy; mtcroscoolc; ~enbranes, neutroonlllc lnflltratlon,
membrane roll, chorlo~ <ves, no, unknown)
PAtholooy; micrnscoolc; cord, neutroPhilic infiltration, u~blllcal
vetn
Patholooy; micrnscooic; cor~. neutrophilic Infiltration, u~billcal
vetn <ves, no, unknown)
P~tholooy:
~embrane
.
H
H
(')
•w
l11
~
I
t-.J
537S •••• VAR
20
53q
5J9
537& •••• VAR
22
540
540
'5377 • ••• VAR
27.
54t
541
537B •••• VAR
21
542
542
'5379 •••• VAR
21
541
543
53RO •••• VAR
8
544
544
'53Al •••• VAR
8
545
545
11 59
•
·-------------· PLACEHTAL EXAMINATION-MICROSCOPIC
~~ f/.l.U...~~ '!.~S<'J~t..':fo..':.,•.;;-;;, :;M:f) '.:'!::.:: t':!
qu,red fot every item exce~t those fw twina onty. (3) DftcriH oil
abnorft'IOiitiea in the space ot bott. . of sheet. (4) e....,.,. at l•at
-·
3 sections; cord, ....,.brane roll, oncl plocentw. (5) UM looll pelnt
3. DATE
D.., j Y
'
1
2. MICROSCOPIC EXAMINATION BY:
Mo.;
.
5. WAS AMNION AVAILABLE FOR EXAMINATION
4. DESIGNATION OF PLACENTA DESCRIBED ON THIS FORM
9
c;J Single Birth
9
Twin A
Twin B
9:;:8":;:::
(l......lfy lool-)
!
yHo
yY•s
6. CORD
i9. u..m..l A.....,
7. NEUTROPHILIC IHFIL TRA TION
8. U. .ilicol Vein
9
9 .........
t:;J Slight
Not • -
•I 00
0
r1 Morlcecl
2
Slight
0
0
Not -
0
Slight
t
Morlcecl
•
12. HUMBER OF UMBILICAL ARTERIES
11. THROMBOSIS OF VESSELS
Not ,....
Pre...,t (De-liMo)
9
I 0. Cwcl Sulostence
0I
Net s...,
9
9
~One
Two
13. MIMBRANIS
14. EPITHELIUM OF AMNION
15. Necro•is
Not ,..., ~ Present
: 16. s.,.._ --~loaio
r;
;
9
19. NEUTROPHILIC INFIL TRATIOH OF:
20. Amnion ol M e - • Roll
9
Not ,...,
y
Slight
9
9
Net -
9 p,.....,
•
: 21. Cheri• ol ~ Rell
Monl.ecl
:
9
9
Hat -
t
9
Slltht
9
•
I
9
Present 22. Amnion ol P i a - l Surloce Not s - 0 Slight 0 Markee! 0
1
9
~Slight
Hat seon
c;J Not •...,
:0
Morlcecl
24. F.,.l Surfece Venels 23. Ch..ion ol Plac..,tel StWioce
0 Nat • - 0 Slight 0 Morlcecl
0
18. 8actwiol Coloniea 17.A-IonNooiM
yNatseon
Present
2
-loecl 25. OTHER FETAL SURFACE VASCULAR CHANGES
9
None
y
c;J Thr_._is
"-ala
9
o.t- (0.-'lool
26. MACROPHAGE$
27. In AIN"'Ion or Chori• :::::; Not .... O Pre•ent (conMiinint l l ~...., (conNifto
t
nopig.,...t)
T lott_i_).
28. In Oecidue Not ,..., 0
0
o
Pres-t (contelnint
no plg....,t)
t
f l Pr.aeat (c•tein- CJ Pre•ent (contoinint unknown T i"! h-aiclwin)
I
pig.,...t)
n ...._
r1 ,.,._, (contein-
T
n
(c...tain'"' " - • l....ln)
lftt - 1 - 1 T
I
p,....., (conteinint unknoWft pi-t)
29. TWIN PLACENTAS OHL Y • CLASSIFY DIVIDING MEMBRANES
CJ Monoamnionic-Monochorionic
o (No dividing -ranes pre...,t)
T
30. DECIDUA
31. VESSELS (of lntect, non-otic- ol<l•hl•t
32. Thr-iooois
, 33. Fillri-hl
r l Not ••- 0 Preo-t ::J Unable te
• r1 Net s..., 0 Pre•0
1
a e.a,UIIte
:0
1
35. NECROSIS 36. At Margin Not morlcecl
9
9
'
39, NEUTROPHILIC INFILTRATION
•o. At Margin
C
0
Not -
0
Slight
t
0
: o
•
43. L. YMPHOCYTIC INFIL. TRATIOH
44. At Mo,.ln
Not ,...,
Slltht
Marlcecl
9
9
Av.,...
9
o
Ao•-•
0
t
p,....,,
I"'
Slight r1 Morlcecl
T
1
9
1
p,....,,
t
Q
N-1 (clum,..
on 30!5 ol villi)
154. STROMAL FIBROSIS
n
0
0
Nat -
CJ
Unable to
e.aluote
Morkecl
2
Slight
1
t
p,....,,
(D..crlbe)
0
t
0
Markee!
2
1""
Leu..,_ 9
=-;.'
..':'ante
0
t
0
Exceaoive 1..
t - plac-te
PATHOLOGICAL EDEMA
Net ..... 0 Pr••
o
t
(Descriloe)
0
157, HUCLEATI!D
RBC IH FETAL CIRCU-~51- MELANIN
LA TIOH 0 Net 0 p,....,,
0 Nat s...,
Collob. .tive R:ea-rcft
P•ineNI R. . _rch Bnnch, NINDB, NIH
B......... U,Mol.
:::J Slight :::J Morlcecl
1
2
(PATH-2)
:~.In a... us
Nat • ..., 0
I
51. TIIIIMIMAL VILLI
o
2
1
:0
0
Marked
t
:42.1n Baealls
; r1 Net •..., CJ Slight
:o
Unable to
evaluate
2
0
o
1
0
Preaent
1
50. SYHCYTIUM-HUCLEAR CLUMPING
HOFBAUER CELU
n F - D ~~~any
56. MICRO INFARCTS (oo speclllecl in - • I )
0 Net s..., ::J
0
•~eluate
!xceaaive
52. LANGHANS' LAYER
0
z
: 45. Ill c._.....
: r1 Nat • - 0 Slltht •T
t
9
•1· CYTOTROPHOBLAST
OF COLUMNS
48. Fibrin Depesitlon
c;:::J
0
C
: 38. In BaiCIIIo
Unule to; 0 Not morkecl
0
: 41. In C.peuleria
:0 Net -
Merlcecl
34.Ath..
CJ Not seen
o
Unable to
e.aluete
2
•' 37. In Capau...ie
:. r1 Net -"eel r1 Merlcecl
0
1
=.:..te
Y
Monl.ecl
0
Unknown
Page 1 oi2
PA'lli-2
I •5
PLACENTAL EXAMINATION-MICROSCOPIC (Continued) 60. INTERVILLOUS SPACE
61. INTERVILLOUS THROMBI 0 Not 0 Pre-, RBC I n 0
0 ,.,._,
6%. IP THROMBI PRESENT
0 No eoliocent viii-
RBC "--yaeol
o
2
63. MARGINAL SINUS THROMBI
0 Not 0
RBC l-et
p,.-,
0
I
u.....,
0
Prea-, RBC he.elyaeol
2
65. APPARENT MATURITY OF PLACENTA
0
20 __...
0 20.27 • . - .
•
0
1
Aoll- viii••
lnNrctlon ....
037--···
0211-36 ......
•
66. MICROSCOPIC EXAMINATION WAS CONE WITH KNOWLEDGE THAT•
0 Cllnlcol •-•• .,. - · - f• 0 Cllnlcol •-•• « - - I«
, IIIOthw.,. belly - • - 1
a IIIOthw • boby - • olon-1 67. PRESENCE OF OTHER ABNORMALITIES
0 No obn-lltloo oth... then tiloao ·-lfleol • ...._
0
lnfarctt011 • ..,.
64 SICKLING ( - 1 bl....)
ONotnoteol OPrea
o
,
0
0
•
With no kn_l..... of tho coao Abn--lltloa otilw ..,_ tiloao •-lfleol ot.
1
6L DESCRIPTION OF ABNORMALITIES CHECKED AND OTHER PERTINENT FINDINGS. IDENTIFY EACH COMMENT BY THE
CORRESPONDING ITEM NUMBER.
,~···~
69. PINAL DIAGNOSIS
USE
Collobwotl- R....rch
Pwinotol Roaoorch Brenc:ll, NINDB, NIH
Bothe.... 14, Mol.
(PA TH·2)
Pov• 2 of 2
PATH-2
Form
Ite~
~umbers
link~d
ITE-.
DATA
ON
IfF."'
to Oata Items on
CARO
NUM
537
517
tl2 • PATH•2 120?
t34.PUH•2 1202
tH.PATH•2 1202
15
l'l
11
t6
20
1702
2'1
120?
11.02
A
135.PATH•2
tl6.PATH•2
1l7.PATH•2
1 38.PATH•2
23
24
25
A
5l80 •••• VAR
544
544
A
5l8t •••• VIIR
545
545
microscopic; ~e~branPs, macrophaqes fn decidua <ves, no,
unknown)
Patholoqy; mtcroscoptc, examination bV
Patholoqy; microscopic, date Cday)
Patholoqy; mtcroscootc, date <~o)
Patholooy; mlcroscoo1c, date <vr>
Patholoov: mlcroscootc, dest~ndtion of placenta, pluralitv
Patholooy; mtcroscootc, a~nton available for examination
Patholoav: microscopic; cord, neutroohillc Infiltration, umbilical
veln
Patholoav: microscopic; cord, neutroohlllc 1nf1ltrat1on, u•blllcal
veln
Patholoav: microscopic; cord, neutrophilic infiltration, UMbilical
vein (yes, no, unknown)
P~tholoav: ~lcroscootc; cord, neutrophilic Infiltration, umbilical
artery
Patholoay; microscootc; cord, neutrophilic infiltration, cord
suhstance
Patholoav: mtcroscoolc; cord, thrombosis of vessels
Patholooy; cord, arteries, number
Patholoav: microscoolcl cor~. nu•ber of u•blllcal arteries
PathoJoav: mtcroscoolc: membranes, eplthellU~ of amnion, necrosis
Patholoay; microscopic; ~Pnbran~s, ~plthellum of ~mnion, squa~ous
2
1
1
1
4
5
1202
F'R0114
18
22
23
24
25
P~tholoqy:
CJ
1 J~. PATH•2 1202
26
26
10
140. PATH•2 1202
27
27
11
12
141 .PATH•2 1202
Sl&R •••• VIIR
2A
';)0
t:l
15
29
lb
t42.PATH•2 1202
t4l.PATH•2 1?02
144.PATH•2 1?02
28
530
29
10
17
t45.PATH•2 1?02
32
12 Patholooy;
mlrr~scooic;
~~'hranes,
epithellu~
ttl
146.PATH•2 1202
H
nodosum
33 PathoJoqy; microscopic;
me~branes,
epithelium of amnion, bacterial
()
00
~tcros.
DATA TTEH NAMF.
ID
SJ7J •••• V-R
•
•w
PlacPntal F.Kam -
TO
FOR"''
1-f
1-f
PAT~·2,
JO
31
31
metaol~sla
of amnion, amnion
coloni~s
20
~
I
N
141.PATH•2 1202
34
20
5174 ••• • V"R
5JR
20
5375 •••• VIIR
539
21
5178 •••• VAR
542
21
t4R.PATH•2 120?.
35
21
537Q •••• VIIR
'543
22
5376 •••• VIIR
540
14 Patholoqy; microscopic; me~br~nes, neutrophilic
membrane roll, amnion
538 Patholoqy; microscooic; me~branes, neutroohlllc
membrane roll, amnfon
539 Patholoqy; microscopic; membranes, neutroPhilic
membrane roll, amnion (yes, no, unknown)
542 Patholoay; mlcroscooic; membranPs, neutrophilic
15 Patholoqy; microscooic; me~branes, neutrophilic
543 Patholoov: microscopic; me•branes, neutroPhilic
membrane roll, chorion (yes, no, unknown)
540 P~tholoqy; microscopic; membranes, neutrophilic
placental surt~ce, amnion
intlltratton,
lnfiltratlon,
infiltration,
intlltratlon,
infiltration,
lnfiltratlon,
1nftltrat1on,
For~
Item Numbers linked to nata Items on PATH-2,
ITEM
ON
FOHM
22
?.2
.
H
H
(')
•w
1.0
OATA
Il'F.M
CAHO
NUM
FROM
149.PAT1i•2 11.02
36
10
5177 •••• VAR
541
?.3
150.PATH•2 1202
37
?4
151.PATH•2 1?0?.
38
25
152.PATH•2 1?0?
39
1.7
1.1
27
1Sl.PATH•2 1202
5170 •••• VAR
517t •••• VAR
532
534
?.1:1
1.1:1
29
5372 •••• VAR
154.PATH•2 120?.
155.PATH•2 1?01.
12
H
H
lb
H
)II
40
156.PATH•2
157.PATH•2
159.PATH•l
159.PATti•2
1&0.PATH•2
1b1.PATH•2
1&1..PATH•2
11.02
1?0?.
1?02
1202
11.01.
11.02
1202
40
535
42
44
4'5
46
47
49
4Q
50
51
Placent~l
EK8m -
TO
~fcros.
OA U
16 Patholoay: ~icroscoplc;
olacental surf8ce,
541 Patholooy; mtcroscooic;
Placental surface,
17 Patholony: mlcroscoolc;
ol~centa1 surface,
18 Patholoay: mlcroscoolc:
surface vessels
19 Patholoay; microscooic;
other
41 Patholony; microscopic:
513 Patho\oay: microscopic:
514 Patholoay; microscopic;
£yes, no, unkno-n)
516 Patholoay; microscooic;
43 Patholoay; microscooic:
44 Patholoay; microscopic;
t-In placentas
45 Patholoay: microscoolc;
46 P~tholoqy: mtcroscoric;
47 Patholoay: microscoPic;
48 Patholooy: ~lcroscooic;
49 Patholooy: mtcroscoolc;
~o P~tholoay:
~icroscoplc;
51 Patholoay;
~icroscooic;
T fF.M NAME
me~branes,
neutrophilic infiltration,
amnion
me~branes, neutrophilic infiltration,
amnion (yes, no, unknown)
me~branes, neutroohlllc infiltration,
chorion
me~branes, neutrophilic infiltration, fetal
~e~branes,
fetal surface vascular changes,
ne~branes,
~enbranes,
macrophaaes In amnion or chorion
macrophaaes in amnion or chorion
nenbranes, macrophaaes In amnion or chorion
~enbranes, macroohaaes In decidua
membranes, macrophages in decidua
membranes, class. of divldln~ membranes of
jectdual vessels, thrombosis
vessels, fibrinoid
decidual vessels, atherome
decidual necrosis, margin
decl~ual necrosis, capsularls
decidual necrosis, basalis
decidua, neutrophilic Infiltration at
dect~ual
~araln
i
~
41
16l.PATH•2 1202
52
~2
42
164.PATH•2 1202
5)
~3
44
45
165.PATH•2 120?.
1&6.PATH•l 1202
54
55
S4
46
167.PATH•2 1202
56
56
41:1
1&8.PATH•2 1202
57
57
49
169.PATH•2 1202
SA
58
o;o
52
t70.PATH•2
17t.PATH•2
172.PATH•2
t73.PATH•2
59
60
60
61
61
62
62
53
S4
1202
1202
1202
1202
55
59
P~tholoay;
mtcroscootc;
capsular1s
Patholooy; microscopic;
basalis
Patholoay; microscooic;
Pat~oloay; microscopic;
capsular is
Patholoay; microscopic;
basalis
Patholoay: mlcroscoolc;
deposition
Patholoay; mlcroscoolc;
chanoe
Pat~oloay: microscopic:
Patholooy: mlcroscoolc;
Patholooy; mlcrnscoolc:
Patholoay; mtcroscooic;
decidua, neutroPhilic infiltration in
decidu~,
neutroPhilic infiltration tn
decidua, lymphocytic infiltration at margin
decl~ua, lymphocytic Infiltration In
decidua, lyMphocytic Infiltration In
decidua, cvtotroohobl8st of columns, fibrin
decidua, cytotrophoblast of columns, cystic
decidua,
terminal
terminal
terminal
syncytiuM, nuclear clumplnq
villi, Langhans' laver
v1111, Hofbauer cells
villi, stromal fibrosis
Form Item
H
H
•()
•~
0
i
I
N
~umbers
linked to nata Items on PATH-2, Placental f.xam -
ITEM
llUA
ON
IrEM
FOR"'
Ill
CARD
NIIM
FROM
55
56
57
174.P~TH•2 1202
t75.PATH•2 1202
1 76.PATH•2 1202
61
64
65
58
61-62
1 77. PATH•2 1202
17R.P~TH•2 1202
66
b7
63
64
t7q.p~TH•2 1202
180.PUH•2 1202
6q
70
65
181. PATH•2 1202
71
6b
67
182.PUH•2 1202
t8J.PATH•2 1202
72
71
rn
63 Plltholooy: microscopic:
64 P.:ttholoov: microscopic:
65 Patholooy: microscopic:
circulation
66 Patholooy: microscopic:
fi8 Patholooy: microscopic:
villous Infarction
69 Patholoov: microscopic:
70 Patholoqy: microscopic:
blood
71 Plltholooy: mlcroscooic;
Placenta
72 Patholoov: Mlcroseopicl
73 PRtholoayJ Mlcroseooie:
~teras.
DA U
lfF.M N AMF.
terminal villi, pathological ede•a
terminal villi, micro infarcts
terminal villi, nucleated RBC in fetal
terminal villi, melanin
intervillous space, thrombi and ad1acent
intP.rVillous space, marginal sinus throMbi
intervillous space, slckltnq: Maternal
lntervlllous space, apparent Maturity of
exam
oth~r
with kno•ledoe of case
abnorMalities present
~one
DEFTITITICN CF CCDES
?LACEll'TAL n~.l-!:!TAT:ON - :•!:i:CROSCCPIC
FORM PATH-2
CARD 12022
CARD
COLUMN
FIELD
Card Number
Code: 1
1
2. Form Number
Code: 202
2-4
3· Revision Number
rt
Code: 2 - Form dated: ~/59 (Revised coding 1965)
4. NTIIDB Number
Item 1
Nine-digit DUmber for Patient Identification
Code: As given
6-14
5· Microsco~i=
Examination By
Item 2
Code: See "Examiners" - 12012 card, pages 12-13
15-16
6.
Date
Item 3
Six-digit code for:
MOnth (cols. 17-18)
Day
(eels. 19-20)
Year
(cols. 21-22)
Code: As given 99 - MOnth, Day and/or Year Unknow. 17-22
7·
Desi~t!on
23
8. Item
Code:
of
P~acenta
0
1
2
3
4
-
9
-Unknown
Single birth
First of Multiple
Second of Multiple
Third of Multiple
Fourth of Multiple
Amnion Available for Examination
Item 5
Code: 0 -No
1 - Yes - not further ~ualified
2 - Yes - roll only
3 - Yes - fetal or placental surface only
9 - Unl:alow.
II.C.41
24
PA'!H-2
DEFDTITION OF CODES (continued)
FORM PATE-2
Card l2022
CARD COLL'MN CORD
9· Neutronhilic Infiltr~tion Items 8, 9 and 10 Three-digit code for: Umbilical Vein
(col. 25)
Umbilical .Arterz (col. 26)
Cord Substance
(col. 27)
Code for each column:
0 - ~Tot seen
l - Slight
2 - Marked
3 - Combination of codes 1 and 2, moderate
9 - UnknoWD.
25-27
:o. Thrombosis of Vessels
Item ll
Code: 0 - Not seen
1 - Present
28
9 ll. UnknoWD.
NUmber of Umbilical Arteries
Item 1.2
Code: 1 - One
29
2 -Two
9 - UnknoWD.
MEMBRANES
l2. Enithelium of Amnion
:tems 15, :6, 17 and 18
Four-digit code for:
Necrosis (col. 30)
Code: 0 - Not seen
l - Present
not qualified fUrther
2 - Pre sen:t - slight
3 - Present - marked
9 -Unknown
Squamous Meta"Olasia (col. 31)
Amnion Nodosum
(col. 32)
Bacterial Colonies
(col. 33)
Code for each column: Same as in Field 10 II.C.42 Reproduced at the National Archives
30-33
PA'IH-2
DEFDTITION OF CODES (continued)
FORM PATH-2
Card J2022
CARD
COLUNN
13. Neutronhilic Inf~1tration of:
Items 20, 21, 22, 23 and 24
Five-digit code for:
Amnion of Membrane Roll
Chorion of Membrane Roll
-~ion of Placental Surface
Chorion of Placental Surface
Fetal Surface Vessels
Code for each column: Same as in Field 9 34-38
(col.
(col.
(col.
(col.
(col.
34)
35)
36)
37)
38)
14. Other Fetal Surface Vascular Changes
Item 25
Code: 0 - N::lne
1 - Thrombosis
2 - Necrosis
4 - Other than specified above
7 - Combination of codes 1, 2 and 4
39
15. Ma.cronhage
Item; 27 and 28
Fbur-digit code for:
In Amnion or Chorion
( co1s.
In Decidua
(cols.
Code for each tva columns:
00 - Not seen
01 - Containing no pigment
02 - Containillg meconium
04 - Containing hemosiderin
05 - Combination of codes 01 end 04
01 - Combination of codes 01, 02 and
08 - Containing unknown pigment
11
Combination of codes 01, 02 and
J2 - Combination of codes 04 and 08
13 - Combination of codes 01, 04 and
14 - Combination of codes 02, 04 -<>nd
15 - Combination of codes 01, 02, 04
4o-43
9 - U:ckoown
99 -
4o-41)
42-43)
04
08
08
08
and 08
Unlmo•.ro.
II.C.43 PNIH-2 DEFINIT~U
OF CODES (continued)
FOP.M ?A...""R-2
Ca:::.-d 12022
C.APJ)
F3LD
16.
COLUHN
~::.assification of Dividing Membranes of T-win
Placentas
Item 29
Code: 0 - Single birth
l - ~llOa.mniotic - monochoriomc
2 - Diamniotic - dichorionic
3 - Diamniotic - mollOchorionic
8 - Other than t-.rins
9 - '!Jn.known
DECIDUA
17.
Vessels
Items 32, 33 and 34
Three-digit code for:
Thrombosis
(col. 45)
Fibrinoid
(col. 46)
Atheroma
(col. 47)
0 - Not seen
l - Present
2 - Unable to determine
45-47
9 - Unknown
18.
Necrosis
Items 36, 37 and 38
At Margin
(col. 48)
In Cansularis
(col. 49)
In Basalis
(col. 50)
0 - Not marked
1 - Marked
9 19.
48-50
Un.lalown
Neutrotohilic Infiltration
Items
, 41 and 42
At Margin
(col. 51)
In Cansularis
(col. 52)
In Basalis
(col. 53)
Same as ~ Field 9
II.C.44
51-53
PA'IH-2
DEFnriTION OF CODES (contiDlled)
FOR.\1 PATH-2
Card ::!...2022
CARD
COLUMN
20. Locmphocytic Infiltration
Items
45 and 46
(col. 54)
At Margin
In Ca-o sulari s
(col. 55)
In Basalis
(col. 56)
Code for each colWIIIl: Same as in Field 9 21. of Columns
Items 48 and 49
T-wo-digit co de for:
Fibrin De-oositicn
(col. 57)
Code: 0 - Not seen
1 - Average
44;
9ytot~-ohcblast
2 -
57-58
Elccessi~re
3
4
8
9
- Combination of codes 1 and 2
- !ess than average
- Unable to determine
- tiUlmown
Cystic Change
(col. 58)
Code: 0 - Not seen
1 - Presen-t
9 22. Unknow"ll.
Syncytium. - Nuclear Clumc:!.ng
Item 50
Co de : 1 - Uo I'll'l81.
2 - !ess than normal for ter.n placenta
3 - Excessive for ter.n placenta
4 - Excessive in parts
9 -
59
Uilla:lc•m.
TERMINAL VILLI
24. Ianghens' Layer Item 52 Code: Same as in Fi.eld 10 60
H'o f'bauer Cells
61
Item 53
Code: 1 - Few
2 - MaDy
9 -
Unk:nown
II.C.45
PA'IH-2
:8EFINITICN OF CODES (continued)
?ORM PAT:S:-2
Card 12022
25-
St:-o::nal Fibrosis
Item 54
Code: 0 - riot seen
1 - Present - act qualified fUrther
2 - Present - rare
3 - Present - ~
62
9 - UDkilcwn
26. ?atholoaical Ede::na
Item 55 Code: Same as in Field 25 63
27. Micro Infarcts
Item 56
64
28. Nucleated RBC in Fetal Circulation
Item 57
29. ~.elanin
Item 58
Code: Same as in Field
66
9
lll'l'ERVILIDUS SPACE
30. Ictervillous Thrombi and AdJacent ViLlous Infarction
Items 61 and ~
Code: 00 - Not seen
10 - RBC intact and no adjacent villous seen
ll - RBC intact and adjacent villous seen
12 - Combination of codes 10 and ll
20 - RBC hemolyzed and DO adJacent villous seen
21 - RBC hemclxz,ed: and adjacent villous seen
32 - Combination of codes l2 and 22
67-68
99 - Unknown
31. Marginal Sinus Th."'""mbi
Item 63
Code: 0 - Not seen
1 - 3BC intact
2 - RBC he!!!Olyzed
3 - Combination of cedes 1 and 2
9 - Unknown
II.C.46 PA'IH-2
DEFmiTION OF CODES (continued)
FOR..\1 PATH-2
Card l2022
-F!SLD
CARD
COLul-lN
32.
Sickl.gr: Matern.a.J. Bl.ood
Item
Code: Same as in Field 211 col. 58
70
33·
A"onarent Maturity of Placenta
n
Item 65
1 - Under 20 -.reeks
2 - 20-27 ·..reeks
3 - 28-36 weeks
4 - 37 ~eeks or over
8 - OUable to determine
Code:
9 - Unlclowu
34.
Microsconic Examination Was Done With Knowledge That
66
Item
Code:
72
0 - :rk:l lalowledge
1 - Normal outcome for mther or baby
2 - Abt10r:nal outcome for mther or baby
9 - Unknown
35·
Presence of Other .<lliDOr!!!a.lities
Item
Code:
67
73
Same as in Field 10
II.C.47
PA'IH-2
<t:
~
A
(,)
G
......
;::.
~
0
(,) t'J ...0
S13$SSI\
(,)
......
:::;:
IC\J
....!..
~~
O<t:
...... 0....
gE
i£
&§
,....,
c.J)
u.J
S39t~Hd~'4W
z
c::r:
a::=
~
UJ
::!0 M0\.1.ij'U.~M'!
'0 11 lHcUMJJBN
~
d
+'
~
Q) (.l ~
,....,
c..
<niO~
II.C.48
PNIH-2
PLACENTAL EXAMINATION-MICROSCOPIC
(For Form PATH-2, Dated 11-59)
PURPOSE. The purpose of this examination is to
provide precise, detailed informatioa about
the microscopic appearance of the placenta
and how it may relate to the outcome of the ·
pregnancy for both mother and infant. Report
the informatioa on PATH-2, Placental Ex
aminatioa - Microscopic.
ORDER OF EXAMINATION. For the sake of coo
venience and thoroughness, the order of the
examinatioa is to coaform in so far as pos
sible with the order of items as they appear
on the form.
EXAMINER'S LACK OF BIAS. Insofar as poa
silile, the examiner should have no knowledge
of course or outcome of the pregnancy until
this form has been completed.
WHEN TO USE THIS FORM. This form is to be
used in every case in which the crown-rump
length is 16.5 centimeters or more (gestational
age 20 weeks or more), and in those cases in
which the placenta is intact when the fetus
is less than 16.5 centimeters crown-rump.
EXAMINATION OF SECTIONS. During the course
of this examination, at least three sectioaa
cord1 membrane roll, and placenta - should
be examined. The methods for the preparation
of these aectioaa are outlined in Pathology
Manual, PHS-3222-1, Placental Examinatioa
-Gross.
DESCRIPTION OF ABNORMALITIES.
All ab
normalities are to be described in Item 68.
This includes those abnormalities which are
not specifically mentiooed in the form.
Wherever possible, the item number corres
ponding to the abnormality should be in
cluded with the descriptioa of the abnormality.
If the space at the bottom of the sheet is not
sufficient, additiooal pages may be added.
MULTIPLE BIRTHS. In cases of multiple births,
a separate form is to be prepared for the
placenta of each fetus.
Item 3, Date. Enter date of examination.
Item 4, Designation of Placenta Described on this
Form. Check the appropriate box. In cases
of multiple births with more than two mem
bers, check box •other multiple births" and
enter in Item 68 the number of fetuses an~
the designation of the fetus whose placenta
is described in this form.
lte111 5, Was Amnion Available for Examination.
Self-explanatory.
Item 6, Cord. If abnormalities are present other
than those specified, describe them in Item
68. In particular, if any special sections
have been taken during the course of the
gross examinatioa, describe these fully.
IteM 7, Neutrophilic Infiltration. Self-explanatory.
lte111 8, Umbilical Vein. Self-explanatory.
lte111 9, Umbilical Artery. Self-explanatory.
1.._ 10, Cord Substance. Self-explanatory.
lte111 11, Thr0111bosis of Vessels.
If present,
describe in Item 68 the age of the thrombus,
the size of the vessel and the presence or
absence of degenerative changes in the wall
of the vessel.
lte111 12, Number of Umbilical Arteries.
planatory.
Self-ex
lte111 13, Membro-s. Self-explanatory.
lte111 14, Epithelium of Amnion.
Self-explanatory.
Item 15, Necrosis. If present, describe in Item 68
with regard to degree and extent.
lte• 16, Squam-• Metaplasia.
Sel£<xplan:atory.
ltelll 17, Amnioa Nodosom. Self-explr.natory.
lte111 18, Bacterial Col011i es. If present, describe
these morphologically, insofar as is possible,
in Item 68.
INSTRUCTIONS
lte111 1, Patiellt Identification. As a mm1mum, enter the patient's name by addressograph or other method. lte• 19, Neutrophilic Infiltration of. Self-explana
tory.
lte111 2, Microscopic Exa111ination By.
and status of examiner. lte• 20, Amnion of Membrane Roll. Self-explana
tory.
F.nter name J:1nu:ary
II.C.49
1960
PA'IH-2 PtACENTAL EXAMINATION- MICROSCOPIC (Coa't)
PATH-2
11-59
Self~xplaaa
1.... 38, In Basalis. This refers to necrosis in
the decidua basalis.
Item 22, Amnion of Placental Surface.
planatory.
Self~x
1..•39, ~eutrophilic Infiltration. Self-explanatory.
Item 23, Chorion of Placental Surface.
planatory.
Self~x
Item 21, Chorion of Membrane Roll.
tory.
1.... 40, At Mar!Jin. Self-explanatory.
Item 24, Fetal Surface Vessels.
1.... 41, In Capsularis. Self-explanatory.
Self~xplaaatory.
a......
Item 25, Other Fetal Surface Vascular
Check the proper box. If chauges are preseat,
describe them in Item 68.
Item 26, Macrophages.
Self~xplauatory.
Item 27, In Amnion or Chorion.
Self~xplaaatory.
Item 28, In Decidua. Self-explaaatory.
Item 29, Twin Placentas Only - Classify DIYidiRt
Membranes. Fill out this item only in the
case of twins. If this is a multiple birth, of
more thau t.vo members, leave this blak aud
describe all the dividing membraues in Item
68. Indicate the relatioaahip of the fetus
described on this form to the other members
of the birth insofar as the dividing meabranes
are concerned.
·
lte• 30, Decidua. If abnormalities are preseat
other thau those specified describe tllem in
Item 68.
Item 31, VesHis. These must be observecl in in
tact, non-necrotic areas of decidua.
lte• 32, Thr-bosis. If present, describe in Item
68 with regard to age, e.rtent, and whether ar
not the lumen of the vessel is a.~mJWed.
1... 42, In Basalis. Self-explanatory.
1... 43, LYftlphacytic Infiltration. Self-explanatory.
1.... ..U, At Mllrgin. Self-explanatory.
1... 45, In Capsularis. Self-explanatory.
1... 46, In Basalis. Self-explauatory.
1... 47, Cytotropl.oblaat of ColuMns. Self-expla
a.atory.
1... 48, Fllwin Deposition. This refers to the
fibrin or fibrinoid deposits which occur in
cytotrophoblast cells as term is approached.
1... 49, Cystic Change. These may form within
the trophoblastic columns. If the change is
present, check. the proper box.
lte• 50, Syacyti. .-Nuclear Clu•ping. At term,
approximately 3~ of all terminal fetal villi
have a syncytial bud attached to their sur
face. Using this as a normal, check the
proper box with regard to syncytial nuclear
clumping in the placenta under examination.
1... 51, TerJ~~inal Villi. If abnormalities other
thau those sr.cified are present, describe
them in Item 6 .
.... 52, La..hana Layer. Self-explanatory.
Item 33, Fllwineid. If present, describe in Item 68
with regard to extent and presence ar ab
sence of luminal narrowing.
1.... 34, A..__. If present, describe in Item
68 with regard to extent and presence ar ab
sence of luminal a.arrowing.
IteM 35, Necrosis. Self-explaaatory.
lte• 36, At Mllrgin. This refers to a.ecroais at tbe
margin of the placenta.
·
Item 37, In Capsularis. This refers to a.ec:ro.is iD
the decidua basalis.
.... 53, HaAauer Calla. Self-explanatory.
•... 54, Str-1 Filwoais. If present, describe in
Item 68 with regard to degree aud distribution.
I..• 55, Pathological Ed-. If present, describe
in Item 68 with regard to extent and distri
buticxa aud roughly estimate what proportion
of villi appear to be involved.
lte• 56, Mlcroinfarcta. Microinfarcts are small
aceas of incipient degeneration of placental
tissue which form a distinct histologic lesion
although they ~aunot be seea. grossly. Most
January 1960
II.C.SO Reproduced at the National Archives
PA'IH-2
PLACENTAL EXAMINATION- MICROSCOPIC (Con't)
PATH-2
11-59
often terminal villi are closely packed in a
microinfarct and often they appear to be
agglutinated by inflammatory cells or de
generated epithelium. The blood vessels are
apparently obliterated.
lt.• 57, Nucleated RBC In Fetal Circulation.
Self-explanatory.
·
lte• 58, M.lanin. This pigment may be present
within, and next to, calcium deposits, in
fibrin masses, in the thickened granular base
ment membrane of villi, and rarely in Hofbauer
cells. It is yellowish-brown in colCX'.
lt.• 59, Patient Identification. As a minimum,
enter the patient's name by addressograph or
other method.
lte. 60, lntervill011s SpacH. If abnormalities
other than those specified are present, de
scribe them in Item 68.
lt.• 61, lntervill... Thr...bi. If nucleated red
blood cells are seen in the substance of such
a thrombus, this should be noted in Item 68.
lt.• 62, If Thrombi PY.sent. Self-explanatCX'f.
lt.• 63, Mlqinal Sin• ThrOMbi. Self-explanatCX'f.
lt.m 64, Sickling (Maternal Blood). Self-explana
tory.
Item 65, Apparent Maturity of Placenta. Self
expl&natCX'f. If question arises as to the
criteria to be used in this estimation, the
examiner is referred to pages 14 and 15 of
the revised form of The Examination of the
Placenta by Dr. Kurt Benirschke.
Item 66, Microscopic Examination Was Done with
Knowledge That. Self-explanatory.
lt.m 67, Presence of Other Abnarma IIties. Check
the appropriate box with respect to presence
of abnormalities other than those specifically
mentioned in the form.
lt.m 68, Description of Abnormalities. In this
space, all those abnormalities previously
noted and all those abnCX'malities not specifi
cally mentioned in this form are to be de
scribed. Whenever possible, include the item
number with the description of the abnormality.· .
Item 69, Final Diagnosis. Self-explanatory.
lt.• 70, Do ~ot Use. This box is to be used by
central office of Collaborative Research for
coding.
1anuary 1960
II.C.Sl
PA'IH-2
PATH-3 Autopsy Protocol
Form PATH-3 was used to provide information obtained from autopsies of
deceased infants or children. Implemented into the study in August 1961, the
form was never revised. Data from PATH-3 were punched onto three cards of the
master file (Table PATH-3.1).
TABLE PATH-3.1 Cards and Data Records by Revision for Form PATH-3
Rev.
No.
Number
Records
1203
1
28,329
Weights of Organs
2203
1
3,083
Summary of Conditions
4203
1
2,172
total for form '
33,584
Card Name
Card
Number
PATH-3:
Diagnoses
PATH-3:
PATH 3:
II.C.53
PATH-3
II.C.54
PA'IH-3
nata Items Referencing Form PATH•], Autoosv Protocol
.. H
H
(")
U1 U1 ~
I
w
DATil
lTEIIol
TrFM
JIV
TO
F')RI4
3647 •••••••
3648 •••••••
1649.PATH•1
36'50.PATH•J
1&"i1.PATH•3
3b"i2.PATH•1
3&5l.PATH•1
3654.PATH•J
3655.PATH•1
3b56.PATH•3
lb"7.PATH•'l
3b58.PI'fH•'l
36'59.PATH•l
3660.PATH•3
3&fo1.PAfH•3
3662.PAIH•3
3663.PATH•1
3664.PATH•J
36fo5.PATH•1
3&fo6.PATH•l
361)7.PATH•J
]b68 •••••••
3669.PAIH•l
lb70 •••••••
1b71.PAIH•3
3672 •••••••
3673.PATH•3
1674 •••••••
1675.PAIH•J
167&.PATH•J
3671.PATH•1
3&78.PHH•3
3b79.PATH•l
36RO.PATH•l
3&111 •••••••
loR:.~ •••••••
3b11J •••••••
36R4.PATH•J
36R!).PATH•1
36fi6.PATH•1
3&117.PATH•l
1&R8.PATH•3
CARll
NUM
1201
1203
1203
1203
1203
1203
1201
1?03
1203
1203
1?03
1203
1203
1203
1203
1203
1203
1203
1101
1203
1203
1203
1201
1201
1203
1203
1203
1203
1203
1203
1203
1?.03
1203
1203
1201
2?.01
.2203
2203
2203
2203
2203
2203
rRO"'
t
6
15
1Q
20
22
24
2R
2Q
JO
31
36
3R
40
42
41
4'5
47
4Q
50
52
56
57
f>1
&1
66
b7
7t
72
n
74
75
7fl
71
7R
t
6
1';
JQ
20
22
24
DA U
TO
TrF.M NAME
5 Card number <sequence, torn type, form number, revlslon number)
~JNOB case number
Autopsy: lab accession numoer
Autopsy: event tyoe
Autopsy: qestatton at birth (w~s)
Autopsy: age ~t de3th, postnatal
Autopsy: hirth wef~ht (qms)
Autopsy: sex
Autopsy: race
Autopsy: race, source of infor~atfon
Autopsy: wefqht at autopsy C~ms)
Autopsy: orosector
Autopsy: mlcroscoP1c done bY
Autopsy: edttor
Autopsy: brain ~isposition
44 Autopsy: patholo~ist, coder
4& Autopsy: ~iagnosis: anatomic, tor abortion
48 Autopsy: ~laqnosls, jerfvej fro~ qross, micro, etc.
49 Autopsy: ~iaqnosis, derivej from PlAcenta, mother, father, etc.
51 Autopsy: ~i~gnosls, sequence number
55 Autopsy; ~iagnosls, topoqr!ohtc, SNOP
14
18
19
21
23
27
28
29
JO
35
37
39
41
42
5& Blan~
60 Autopsy:
~laqnosis,
norpholo~fc,
BlanK
65 Autopsy:
~laqnosis,
etiolo~fc,
SNnP
~~
66
70
71
72
73
74
75
76
77
RO
Autopsy: diAgnosis, tunctfonal, SNOP
Rl3n~
Autopsy:
Autopsy:
Autopsy:
Autopsy:
Autopsy:
Autopsy;
diaqnosis, topoqraohfc, deviations
diagnosis, norpnolo~ic, deviations
~iagnosts, etlplo~ic, deviations
diagnosis, functional, jevfatlons
diagnosis, deqree of Involvement
diagnosis, later9litv
Blan~
5 Card
14
19
19
21
13
SNOP
Blan~
nu~ber
(sequence,
for~
typP, torm
NTNDB case number
Autopsy:
Autopsy:
Autopsy:
Autopsy:
11 Autopsy:
lab accession number
event, type
aestatton at blrtn <w~s)
age at je3th, oostnatal
hirth wel~ht
nu~oer,
revision number)
nata Items
DIITII
JN
TD
F'JRM
HOO.PATH-3
370I.P1Tff-J
l702.PATH-3
3703.PATH-3
.n
•U1
0'1
~
I
w
3704.PATH-1
3705.PATH-3
HO&.PATH-3
1707 .PATH-3
3708 •••••••
3709 •••••••
3710 •••••••
Htl.PAJH-1
371 2.PAJH-J
311 J.PATH-1
3714.PATH-1
371 S.PATH-3
371 &.PATH-3
3717.PATH-J
J718.PATH-3
3719.PATH-1
3720.PATH-1
3721.PATH-1
3712.PATH-3
3723.PATH-3
17 ?4. PAT r• •1
1715 •••••••
rorm PATH-3, Autoosv Protocol
Trf.M
ITE~
3bA9.PATH•3
lb90.PATH-1
3b91.PATH-3
3b92.PATH-3
3693.PIITH•3
3b94.PATH-1
3b95.PIIfH-3
3b96.PATI••l
3697.PATH-3
3698.PUff-3
3699.PATH-J
H
H
Reter~ncln~
CARO
NUM
2203
2203
2203
2201
2201
2203
2203
21.03
2203
2203
FRUIIII
2A
2Q
30
H
3fi
40
45
47
49
52
2703
so;
2201
220]
Sit
62
64
2203
2201
220]
67
70
2'203
2203
2203
74
2203
4203
7A
t
6
15
lf\
17
t'70l
UOl
t?.03
t203
4'703
4203
4201
4203
4203
4203
4203
4203
4'203
4203
4203
4203
n
71
lR
1Q
20
21
2?.
21
24
25
26
2R
30
32
TO
DArA
JfEfll
NAME
?8 Alltopsy: sex
Autopsy; race
Autopsy: placenta, weight Cams>
Autopsy: lengtn: cro•n rumo Cc~)
Autopsy: length: crown heel Cc~)
44 Autopsy: weight, at autopsy ca~s)
4b Autopsy: wetqht: tny~us Caws)
48 Autopsy; weight: heart (g~sl
51 Autopsy: weight: tun~, rtgnt Cgmsl
54 Autopsy; welghtr lung, left Cams>
57 Autopsy: weight: spleen Caws)
61 Autopsy: wetghtl liver famsl
63 Autnpsyr welqhtr a~rena1s Ca•s>
66 Autopsy: welghtr kl1ney, rtant C~ms)
69 AUtopsy: welghtr kl~ney, left (q.s)
73 Autopsy: wetghtr brain (gms)
74 wetahts, how recor1e1
76 Autopsy: hours since death
77 State of hody when recelvP.j
AO Blank
5 car~ number cseauence, for1 type, form number, revision number>
14 NIND8 case nu•ber
15 Autopsy summary: maceration, 1earee
16 Autopsy summary: •alformattons, lethality
17 Autopsy summary: ~alformatlons, 1ajor
18 Autopsy s•1m111ary; 'llaltormatlons, nfnor
19 Autopsy summary; hyaline membrane
20 Autopsy summary: oneumonla, otner than Interstitial or viral
21 Autopsy summary: @rythroblastosls fetalls
?.2 Autopsy summary; lunq, atelectasis
23 Autopsy summary, Pulmonary hemorrhaqe
24 Autopsy summaryJ oetecntae, ott1er than subdural/subcapsulae
?5 Autopsy su•maryJ he•orrhaqes, subdural or subcapsular
27 Autopsy sum111aryr conditions, otner, first
29 Autopsy summary; condttfons, other, second
31 Autopsy sum111ary: conjitions, other, third
RO Blank
?9
32
35
39
1. PATIENT 1DENT1F1CAT10N
AUTOPSY PROTOCOL
2. FINAL DIAGNOSIS
MICROSCOPIC EXAMINATIO'I OF BRAIN
GROSS SECTIO'IING OF BRAIN
01NCLUDED
0
OEXCLUDED
INCLUDED
0
COL.
COOE
I
EXCLUDED
' 6-14 IS
16 17
I
18.19
20 ~ I
• 21-22! ' 23-26; 27.30 i 1
35.3al
I
!
i 39-42/
I
I
'
! 43-461 i! 51-541'
I ss.sai
i
I
: 59.62/ i 63-661 67-701 .I c2ndd
I u:~
CO&..&...t.eO.. ATIV . . . . . . A .. CH
P.:RINATAL FIIESIEA .. CH ... ANCH. NtH. NINO •
• IETHESOA 14. MO.
I
PATH-3
II.C.57
1a.o,
PA'IH-3
~-~~"-•u•-•
1. PATIENT IDENTIFICATION
AUTOPSY PROTOCOL
3. FINAL NOTE (Dioau. .l..,a.S..,._)
C OL.L.Aaollt AT IV& lltS.SKA .. C ... PallttNATAL lltCSIEAIItC:H a .. ANCHo
aK.THaSOA 14. MDo PATH-3 ,... , NIM 0 NINOa
II.C.58
PATH-3
...,
I'· PATIENT
coL.A.-uaz-a
AUTOPSY PROTOCOL
: 7. TIME OF AUTOPSY
6. DATE OF AUTOPSY
13. LENGTH
l'r.
Day
(24 hour clock)
Yr.
D•Y
8. DATE OF DEATH
ltfo.
I
•5. AUTOPSY NO.
!
4. PROSECTOR
Mo.
lO.AGE
9. TIME OF DEATH
(24 , _ , clocld
I
l.MALE
QABNORMAL
1
3. UNDETERMINED
(..,a)
I
i
l.WHITE
I. YES OX
2. FEMALE
liS. RACE
CRCINN RLNP:__ _ _ _ _ _ __
CROWN HEEL---------------(LonQor) FOOT_ _ _ _ _ _ _ __ 112. WEIGHT
11. SEX
14. STILLBIRTH
(-o)
16. SKIN
QNORMAL
IDENTIFICATION
i
2. NO
2. NEGRO
3.0THER _____________________
I
I. MACERATION SLIGHT
2. MACERATION MODERATE
3. MACERATION SEVERE
4. EDEMA, GENERALIZED
5. EDEMA, LOCALIZED
6. POOR TURGOR
7. PALLOR
B. ICTERUS
9. CYANOSIS, GENERALIZED
10. CYANOSIS, LOCALIZED
QNOT EXAMINED
IX
11.
HE~RHAGES
12. MEC()IIUM STAINING, FRESH
13. ABNORMAL PIGMENTATION
14. SIGNS OF WEIGHT LOSS
15. SCALING
16. SCLEREMA
17. NAILS
18. FORCEPS MARK
19. CORD MARK
20. NEEDLE PUNCTURE MARK
21. WOUNDS
22. SCARS
23. HAIR COLOR----------
24. BODY HAIR
25. DERMATOSES
26. TUMORS
27. MALFORMATIONS
28. OTHER
17. EXTERNAL LYMPH NODES
QNORMAL
OX
QABNORMAL
,
QNOT EXAMINED ox
COI.l.A80JIItATIVC liiiCSCA(IIICH PI!JIItiNATAL.. liiiii:S&AJIII:CH 8(111ANCH. NIH. NINO.
SIETHIESOA 14. MD. PATH-3 ,••• ., II.C.59
PA'IH-3 11. PATIENT
AUTOPSY PROTOCOL
IDENTIFICATION
I
18. HEAD AND NECK
QNORMAL
OX
QABNORMAL
I
QNOT EXAMINED
OX
1. DCCIPITO FRONTAL CIRCUMFERENCE
2. FACIES
3. CAPUT -----------------c~
4.MOLOING 5. PUPILS
6. IRIS COLOR
7. EYE, OTHER
8. EARS, PINNAE
9. EARS, AUDITORY CANAL
10. NARES
11. CHOANA 12.MOUTH 13. TONGUE
14. PALATE
15. TEETH
16. MANDIBLE
17. NECK
18. ANENCEPHALY
19. MALF~MATIONS
20. OTHER
19. CHEST
QNORMAL
ox
QABN~MAL
I
QNDT EXAMINED
ox
1. CIRCUMFERENCE AT NIPPLE LINE
2. SYMMETRY
-----------------C~
3. NIPPLES
4. MALFORMATION 5.0THER 20. ABDOMEN
ON~MAL
ox
OABN<RMAL
I
0
NOT EXAMINED
ox
1. CIRCUMFERENCE OF ABDOMEN AT UMBILICUS
3. COLOR OF UMBILICAL CORD
4. INFLAMMATION OF UMBILICAL CORD
-------------------~
5. HERNIAS
OPTIONAL. MBASURBMBNTS
6. OMPHALOCELE
2. UMBILICAL STUMP 7. MALFORMATIONS
8. OTHERS
LENGTH ---------------CM. COL.L.AeO.-ATIVIE IIIIESIEA"C:H
PK,.INATAL. AIESIIlA .. CH IS"ANCH, NIH,
81ETHI:SDA.
PATH-3 ,.,_.,
NINO.
14, MO.
PA'IH-3
I'· PATIENT IDENTIFICATION
I
AUTOPSY PROTOCOL
21. BACK CJNORMAL
QABNORMAL
1
0><
0 NOT EXAMINED '"
1. CURVATURE OF SPINAL COLUMN
2. SPINA BIF IDA
3. MENINGO-MYELOCELE
4. OTHER MALFORMATICJIIS
5. OTHER
22. GENITALIA CJNORMAL
Ol<
CJABNORMAL
1
23. ANUS
CJNORMAL
CJABNORMAL
Ol<
1
24. EXTREMITIES
CJNORMAL
ox
CJNOT EXAMINED
1. VULVA 2. URETHRAL ORIFICE
3. VAGINA
4. PEtiiS CIRCUMCISED
5. PENIS
6. TESTIS UNDESCENDED
7. TESTES
8. MALFORMATION
9. OTHER
'"
1. PATENCY 2. POSITION 3. FISTULA
4. MALFORMATION
5. OTHER
CJNOT EXAMINED
"'
1. MUSCLE MASS
QABNORMAL
CJNOT EXAt;IINEO
2. NUMBER OF FINGER~
3. NUMBER OF TOES
4. MALFORMATION
5.0THER
'"
25. OiEST WALL
QHORMAL
ox
RIGHTO LEFT[
CJABNORMAL
1
4.EOEMA
5. t.t.JSCLE 6. BREASTS
Cl NOT EXAMINED
IX 1. PNEUMOTHORAX, LEFT _ _ _ _ _ _ _ _ ,cc.
2. PNEUMOTHORAX, RIGHT
CC.
OPTIONAL /IIBASURBMBNTS
3.SUBCUTANEOUS FAT, THICKNESS·---------
COLL.AaOJtATIVII ftKS.ARCH ~-NNiiTAL JtESCARCH ...ANCH, NIH, NIND•
•liTH.. lOA
I~
PATH-3
,,.., MD.
II.C.61
PA'IH-3
AUTOPSY PROTOCOL
26. ABDOMEN, INTERNAL
QNORMAL
QABNORMAL
OK
1
QNOT EXAMINED
OK
!.SUBCUTANEOUS FAT AT UMBILCUS
---------CM.
2. CONTENTS _ _ _ _ ____,cc.
12. ABDOMINAL MUSCULATURE
13. SITUS
3. DIAPHRAGM
LEFT: _ _ _TH RIB, I. C. SPACE
14. RIGHT UMBILICAL ARTERY ABSENT
RIGHT:
TH RIB, I. C. SPACE
OPTIONAL MEASUREMENTS
4. ROOT OF MESENTERY._ _ _ CM,
5. RADIUS OF MESENTERY._ _ _CM.
6. LIVER EXTENDS
15. LEFT UMBILICAL ARTERY ABSENT
16. URACHUS
17. UMBILICAL VEIN
18. FLUID CONTENT
CM.
19. FLUID COLOR AND ASPECT
BELOW COSTAL MARGIN IN RIGHT
20. GASEOUS CONTENT
MID CLAVICULAR LINE
7. LIVER MARGIN _ _ _ _ _ CM. IN
21. PERITONEAL SURFACE DULLNESS
22. ADHESIONS
MIDUNE
23. PERFORATED VISCUS
8. LIVER DISAPPEARS UNDER LEFT COSTAL
24. DIAPHRAGM, HERNIA
25. DIAPHRAGM, EVENTRATION
MARGIN
CM. FROM MIDLINE
9. GALL BLADDER EXTENDS
CM.
26. INTERNAL GENITALIA
27. MALFORMATION
BELOW LIVER EDGE
10. SPLEEN EXTENOS,_ _ _ _,CM. BELOW
28. OTHER
COSTAL MARGIN
11. BLADDER EXTENOS,----CM. ABOVE
PUBIS
27. CHEST, INTERNAL
QNORMAL
QABNORMAL
OK
1
1. FLUID CONTENT
0
NOT EXAMINED
""
RIGHT PLEURAL CAVITY_ _ _ _ _ _ _
7. PLEURAL SURFACE
8. MEDIASTINUM
cc.
2. FLUD CONTENT
LEFT PLEURAL CAVITY _ _ _ _ _ _ _ CC.
3. PERICAROIAL CONTENT 9. PERICARDIAL SURFACE
10. THYMUS
11.SUP. V.CAVA
12. LEFT SUP. V. CAVA
CC.
4. THYMUS WT. - - - - - - - - GMS.
OPTIONAL MEASUREMENTS
S. CARD10-THORACIC RATIO _ _ _ _ _ _ _ _ CM.I.-----CM.
6. THYMUS MAX. DIAMETERS: _ _ X - - X
-----CMS·
COL.L.A.OIIIIAn VK. IIII:SKAIIICH
Plt! .. fNATAL. IIIII:.KAIIIICH B .. ANCH. NIH. HIND.
BKTHII:SDA
1••
PATH-3 ,... ,
MD. Reproduced at the National Archives
13. ABN. VESSELS, DIAPHRAGM
14. MALFORMATION
15. OTHER
II.C.62 PATH-3
,1. PATIENT IDENTIFICATION
AUTOPSY
PROTOCOL
28. HEART & GREAT VESSELS
QNORMAL
OX
QABNORMAL
I
QNOT EXAMINED
IX
19. RIGHT ATRIUM
1. HEART WEIGHTr_ _ _ _ _ _ GMS.
2. HEART & LUNG WEIGHT_ _ _ _ _ _ _ GMS.
20. COR~ARY SINUS
21. SUPERIOR VENA CAVA
(IF MALFORMATIONS PRESENT)
22. INFERIOR VENA CAVA
3. DEFECT OF VALVE OF FORAMEN
OVALE: _ _ _ _ _ _ _ _
23. FOSSA OVA LIS
24. FORAMEN OVALE, CLOSURE
c~
4. TRICUSPID VALVE CIRC. _ _ _ _ _ CM.
25. TRICUSPID VALVE
5. PULMONARY VALVE CIRC.
6. THICKNESS RIGHT VENTRICLE
CM.
CM.
26. TRICUSPID ATRESIA
7. MITRAL VALVE CIRC.
CM.
27. RIGHT VENTRICLE
8. AORTIC VALVE CIRC.
CM.
9. THICKNESS LEFT VENTRICLE
CM.
28. VENTRICULAR SEPTUM
29. PULMONARY INFUNDIBULAR STENOSIS
30. PULMONARY VALVE STENOSIS
10. ATRIAL SEPTUM (SEPTUM SECUNDUM
31. PULMONARY VALVE ATRESIA
DEFECT)
M.
11. VENTRICULAR SEPTAL DEFECT
32. PULMONARY ARTERY
33. LEFT ATRIUM
34. PULMONARY VEIN DRAINAGE
A-V Co.IMUNIS TYPE - - - - - - C M .
12. VENTR. SEPTAL DEFECT
35. MITRAL VALVE
MEMBRANOU
CM.
13. VENTR. SEPTAL DEFECT MUSCULAR
36. MITRAL A TRES lA
37. LEFT VENTRICLE
-----CM.
38. AORTIC VALVE
39. AORTIC ATRESIA
OPTIONAL lriEitSUREMI!NTS
14. FOSSA OVALIS DIAMETER-----CM.
15. FCRAMEN OVALE PATENT FOR PROSE
40.AORTA
41. CORONARY ARTERIES
42. COARCTATI~ OF AORTA
- - - - - C M . I N DIAMETER
16. CIRCUMFERENCE OF LARGER OF LEFT CCMAON
43. RIGHT AORTIC ARCH
CAROTID OR SUBCLAVIAN-----CM.
44. ANOMALOUS GREAT VESSELS
17. CIRCUMFERENCE OF AORTIC ISTHMUS-----eM.
18. MAX. CIRC. DUCTUS ARTERIOSUS
CM.
45. PATENT DUCTUS ARTERIOSUS
46. ENDOCARDIUM
47. MYOCARDIUM
48. MALFORMATION
49. OTHER
COLLAaOftATIVW: III:KI&AJitCH
PEJitiNATAL fiiCSilAJitCH B.. ANCH. NIHo NIN-;)8
PATH-3
,... ,
a&TH&IOA 14. MO.
PA'IH-3 ... ,
c: 01.. "-aazz-a 1. PATIENT IDENTIFICATION
AUTOPSY PROTOCOL
29. LUNGS
ONORMAL
ox
OABNORMAL
t
0 NOT EXAMINED
ox
I. WT. RIGHT LUNG
GMS.
2. WT. LEFT LUNG
>.MS.
3. NUMBER OF LOBES, RIGHT_ _, LEFT_ _
30. SPLEEN
ONORMAL
ox
1. WT. SPLEEN
OABNORMAL
t
4. RIGHT LUNG DOES NOT FLOAT IN WATER
S. LEFT LUNG DOES NOT FLOAT
6. RT. LUNG
7. LT. LUNG
8. AERATION
9. CUT SURFACE
10. CONSISTENCY
11. PLEURAL LYMPHATICS
12. EMPHYSEMA
13. INTERSTITIAL EMPHYSEMA
14. PLEURA
15. BRONCHI
16. BRONCHIAL MUCOSA
17. BRONCHIAL CONTENT
18. MALFORMATION
19. OTHER
0.,. NOT EXAMINED
-------'GMS.
3. CAPSULE
4. SUPERNUMERARY
S. MULTIPLE
6. ABSENT
7. CONSISTENCY
8. CUT SURFACE
9. MALFORMATION
10. OTHER
OP.170NAL MEASUREMENTS 2. SIZE _ _ ,. _ _ ,. _ _CMS.
31. LIVER
ONORMAL
ox
0 ABNORMAL
t
0 NOT EXAMINED
'"
1. WT. L I V E R - - - - - - - GMS.
8. CAPSULE 9. PORTAL VEIN
10. UMBILICAL VEIN
11. DUCTUS VENOSUS
12. CUT SURFACE
13. CONSISTENCY
14. TWO TONE LIVER
COLOR RT. _ _
COLOR LT. _ _
15. GALL BLADDER
16. BILIARY TREE
17. BILE COLOR_ _
18. MALFORMATION
19. OTHER
OPTIONAL MEASUREMENTS 2. SIZE_,._,.__CMS.
3. CIRC. DUCTUS VENOSUS _ _ _ _ _ _ CM.
4. SPHINCTER (PORTAL END) OF DUCTUS,
DIAMETER
CM.
S. PORTAL SINUS CIRC. _ _ _ _ _ _ _CM.
6. RT. PORTAL V. CIRC.
7. BILE _ _ _ _ _ _ CC.
CM.
C:OI.I...AIIOIIIATIVIl PIII!.CAIIIC:H
PATH-3
PEfUNATAL. _.IE.SIEAfltCH I!IIIIANCH. NIH. NINOII
I!IETHIIE.SDA ··• WO.
CO-ell
PATH-3
AUTOPSY PROTOCOL
32, PANCREAS
QNORMAL
ox
QABNORMAL
1
QNOT EXAMINED IX 2. SHAPE
3. ACCESSORY
4. CUT SURFACE COLOR
S. CUT SURFACE LOBULATION
6. CONSISTENCY
7. MALFORMATION
8. OTHER
OPTIONAL MBASUR&IBN'n 1. PANCREAS Size...__,.__,. -CMS. 33. G. I. TRACT
QNORMAL
ox
QABNORMAL
1
0 NOT EXAMINED IX OPTIONAl. MBASURBMBNn
I.
2.
3.
4.
STOM. CONT·------..1.~" 1C, (APPROX.)
JEJ.-ILEUM LENGTH
CMS.
LG. BOWEL LENGTH
CMS.
JEJ.-ILEUM MAX. DIAM. _ _ _ _ _ _ _ _ _MM.
S. LG. BOWEL MAX. DIAM. 34. ADRENALS
QNORMAL
ox
QABNORMAL
1
MM.
6.
7.
8.
9.
10.
11.
12.
13.
14.
IS.
16.
17.
18.
ESOPH. EROSION
ESOPH. ULCERS
ESOPH. HEMORRHAGE
ESOPH. FISTULA
STOM. ASPECT
STOM. CONTENT
STOM. MUCOSA
STOM. EROSION
STOM. ULCERS
STOM. MUSC. DEFECTS
STOM. HYPERTROPHY
PYLORUS DUODENAL ATRESIA
..
0 NOT EXAMINED
AMPULLA PATENCY
JEJ.-l LEAL ATRESIA
JEJ.-ILEAL CONTENT
JEJ.-ILEAL MUCOSA
MECKELS DIVER TIC
PEYERS PATCHES
COLON CONTENT
COLON MUCOSA
MEGACOLON
APPENDIX
ATRESIA OF COLON OR
RECTUM
30. MALFORMATION
31. OTHER
4.
5.
6.
7.
8.
1. ADRENAL WEIGHT (COMBINEDl------GMS.
2. OUTER CORTEX THICKNESS
MM.
3. INNER CORTEX THICKNESS
MM.
C:OLL.AaO"ATIYI& "CSIEARCH CUT SURFACE OUTER CORTEX
CUT SURFACE INNER CORTEX
MEDULLA
MALFORMATION
OTHER
PATH-3
~IE.UNATAL. IIICS&AIIICH aRANCH, NIH, NINOB
eCTHUDA 14. WO,
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
,... , PMH-3 ... ,
I. P.t.TIENT IDENTIFIC.t.TlON
COLR-3222-J
AUTOPSY PROTOCOL
35. KIDNEYS
0 NeftMAL
ox
0 .t.BNORW.L
1
0 NOT EX.t.MINED
tx
I. WT. RT. _ _ _ _ _ _ _ _ _Gt.G.
2. WT. LT.
5. C.o\PSULE
6. FET.t.L LOBUL.t.TlON
7. CYSTS
8. PELVIS
9. URETERS
10. VESSELS
11. CeftTEX
12. PYR.t.MIDS
13. C.o\LYCES
14. VEINS
15. W.LFORW.TlON
16. OTHER
GMS.
OP1TOHAL MEASUREMBNTS
3. SIZE RT. _ _ ,. _ _ ,. _ _CM.
4. SIZE LT • - " - - " _ _CM.
36. BL.t.ODER
0 NeftW.L
ox
0 .t.BNORM.t.L
1
0
NOT EX.t.MINED
ox
1. CONTENT
2. MUCOS.t.
3. W.t.LL
4. URETER.t.L CftiFICES
S. URETHR.t.
6. VERUMONT.t.NUM
7. W.LFORW.TION
8. OTHER
37. PROST.t.TE
C NORM.t.L
ox
0 .t.BNORMAL
1
0
ox
NOT EU.MINED
OP1TOHAL MEASUREMENTS
I. Dl.t.METER _ _ _ _ _ _ _ _ _ _ _ MM.
2. M.t.LFORM.t. TlON
3. OTHER
38. TESTES
ONORW.L
ox
0 .t.BNORMAL
1
0
ox
NOT EX.t.MIN!D
OPT10HAL MEASUREMENTS
I. SIZE RT._ _ ,. _ _ x--NM.
2. SIZE LT. _ _,._ _ x--NM.
4. CUT SURF.t.CE
5. POSITION
6. HEMORRH.t.GE
7. W.LFCftW.TlON
8. OTHER
3. WEIGHT COMBINED'----------'GMS.
COLL..AeO~~tATIVE
llti!SIEA"CH
P!:RINATAL. fltiUI:AfltCH . . . ANCH. NIH. NINCa
SKTHIESDA t•• ""'0•
PATH-3
'""""
PA'IH-3
11. PATIENT
IDENTIFICATION
I
AUTOPSY PROTOCOL
39, OVARIES
ONCRMAL
ox
OABNORMAL
0
NOT EXAMINED
IX
I
1, WEIGHT CG.ABINED-------GM!i.
OPTIONAL MEASUREMI!KI'S
4. SURFACE
5. CUT SURFACE
6. CYSTS
7, MALFORMATION
2. SIZE R T · - - • - - x - M M .
3. SIZE LT
-•--•--MM. 8. OTHER
40, UTERUS AND TUBES
0
NCRMAL
0
OX
ABNCRMAL
I
0
NOT EXAMINED
IX
1. UTERUS MALFORMATI~
2. UTERUS OTHER
3. TUBES MALFORMATION
4. TUBES OTHER
41. DIAPHRAGM
ONCRMAL
OABNCRMAL
OX
0
NOT EXAMINED
IX
I
1. ANOMALOUS MUSCULAR DISTRIBUTION
2. MA.LFCRMATION
3. OTHER
42. LYMPH NODES
0
NCRMAL
OX
0
ABNORMAL
I
0
NOT EXAMINED
ox
1. LYMPHADENOPATHY
2. CUT SURFACE
3. MALFCRMA Tl~
4. OTHER
COLL.ABO"ATIVE "IESIEARCH
PERINATAL RESEARCH aRANCH, NIH, NINDa PATH-3 ,._.u
e&THESOA 14, MO.
PA'IH-3 j1. PATIENT
IDENTIFICATION
I
I
I
AUTOPSY PROTOCAL
43. DESCENDING AORTA AND MAJOR BRANCHES
0
NORMAL
ox
0
ABNORMAL
,
0
NOT EXAMINED
ex
I. ABNORMAL BRANCHES
2. THORACIC
3. ABDOMINAL
4. INTIMA
5. MALFORMATION
6. OTHER
44. INFERIOR VENA CAVA AND MAJOR BRANCHES
:::J NORMAL
w ABNORMAL
OX
0
NOT EXAMINED
IIX
1
I. THROMBOSIS
2. MALFORMATION
3. OTHER
45. NECK ORGANS
0
NORMAL
OX
0
ABNORMAL
1
0
NOT EXAMINED
ox
I. THYROID WGT. _ _ _ _ _ _ GMS.
3. PARATHYROIDS
OPTIONAL. MEASUREMENTS
4. SUBLINGUAL GLANDS
2. THYROID S I Z E - - • - - • - - C M .
5. SUBMANDIBULAR GLANDS
6. PAROTID GLAND
7. THYROID
8. PHARYNGEAL MUCOSA
9. LARYNGEAL MUCOSA
10. LARYNGEAL CONTENT
II. TRACHEAL MUCOSA
12. TRACHEAL CONTENTS
13. MALFORMATION
14. OTHER
PATH-3
COL.l..ABOfiiiATtYC flllltSEAfiiiCH
PERINATAL. flllltSEAIIICH IIJIItANCH. NIH. NINDB
BETHIESDA
MO.
<a-et)
t••
II.C.68
PA'IH-3
C OL.A -.1222-.1
1. PATIENT 1DENT1F1CATlON
1-<11
AUTOPSY PROTOCOL
46. BONE
QNORMAL
...
QABNORMAL
1
...
QNOT EXAMINED
1. RIB CDSTDCHONDRDL.JUNCT
2. CANCELLClJS
3. CORTEX
4.MARRON
5. MALFORMATION.
6. OTHER
47.MUSCLE
QNORMAL
...
QABNORMAL
1
...
QNOT EXAMINED
!.SYMMETRY
2. MOISTNESS
3. COLOR
4. DEVELOPMENT
5. MALFORMATION
6. OTHER
48. SCALP, SKULL AND SPINAL CORD
QNORMAL
QABNORMAL
QNOT EXAMINED
OX
1
IX
1. BRAIN WE1GHT·------GMS.
2. ANT. FONT
X --CM.
3. POST FONT. _ _ _ X _ _CM,
4. CAPUT SUCCADENUM
S. CEPHALOHEMA TOMA
6. SCALP WoUNDS
7. SUTURES
8. FONTANELLE BULGING
9. FONTANELLES
10. BONES
11. FRACTURE
12. DURA
13. CSF
14. SUBDURAL BLOOD
15. FALX
16. TENTORIUM
17. DURAL SINUS
18. VEIN OF GALEN
19. LEPTOMENINGES
20. SYMMETRY OF HEMISPHERES
21. BASE OF SKULL
22. PITUITARY
23. MIDDLE EARS
24. SPINAL CANAL
25. EXTRADURAL BLOOD IN SPINE
26. MALFORMATION
27. OTHER
49. BRAIN
QCUT LOCALLY
...
QSENT TO NINOB
1
QMACERATED, NO FURTHER EXAMINATION
•
...
QNO PERMISSION
COLLABO,.ATIVI: .. UCARCH
PE .. INATAL "I:III:ANCH B .. ANCH. NtH. NINOB
SII:THIESDA 14• MD.
PATH-3
II.C.69
<e-on
PA'lli-3
....
C OL.R-3Z22-31 AUTOPSY PROTOCOL
SO. BACTERIOLOGY
QNORMAL
QGRO.VTH
ox (NO GR ONTH) ,
QNOT D(JojE
ox
1. ~1ST ORGANISMS Fll.JND
SMEAR
CULTURE
VNG HEART B~
SPSEN
LIVER
I
51. VIROLOGY
i:JNORMAL
QGROWTH
,
ox
QNOT DONE
1. LIST ORGANS EXAMINED
ox
52. PHOTOGRAPHS
QTAKEN
QNOT TAKEN
1. LIST PHOTOS TAKEN
53. X-RAYS
QTAKEN
QNOT TAKEN
1. LIST X-RAYS TAKEN
COI.L.ABOfltATIV1E ,_1ESCAfltCH P1E"INATAL. "1ES1EAfltCH SfltANCH. NIH• NINO. tltETHC,CA 1•. ~0.
PATH-3
<•·•"
PA'IE-3
Form Item
H
H
.• ()
-.J
1-'
i
I
w
~umbers
linked to nata Items on PATH-3, Autoosv Protocol
ITEN
ON
OATA
FOR14
10
CARD
NUM
3722.PATH-3
372l.PATH•l
l724.PUH•3
3717 .PATH•l
l721 .PATH•3
3715.PATH•3
l71A .PATH-3
371t.PATH•3
3712.PATH•3
37ll.PATH•3
3714.PATH•3
3720.PATit•3
3716.PATH•3
3719.PATH•l
36117.PATH•3
3652.PATH•3
3fiBR.PATH•3
3653.PATH•3
3661.PATH•3
36H.PATH•3
3fib4.PATH•3
36b5.PATH•3
3677. PATH-3
3671 .PATH•l
3678.PATH•3
3673.PATH•3
3680.PATH•l
3676.PATH•3
3669.PATH•l
3666.PATH•3
3675.PATH•3
3667.PATH•l
3663.PATH•3
3660.PATH•3
36SO.PATH•3
368t;.PATH•l
3686.PATH•3
3651.PATH•3
3706.PATH•l
3649.PATH•3
3684.PATH•3
3693.PATH•3
4203
4203
4203
4203
4203
4203
4203
4203
4203
4203
4203
4701
4703
4203
2?.03
1203
2203
1703
12'01
1203
1201
1201
1201
1703
1203
1203
1203
1203
1201
1203
1201
1203
1203
1203
11.03
2201
2203
1203
2203
1203
2203
2203
IrF.:M
FROM
26
28
30
21
25
19
22
15
16
17
11J
24
20
23
22
22
24
24
42
76
47
4Q
74
62
75
67
17
11
57
50
72
52
45
40
19
19
20
20
75
to;
15
36
TO
27
29
31
21
25
19
22
15
16
17
18
24
20
23
73
23
27
27
42
76
48
49
74
65
75
10
11
73
60
51
72
55
46
41
19
19
21
21
76
18
18
39
OA rA I fF.:I4 NA14E
Autopsy summary: conditions, other, first
Autopsy summary: conditions, other, secon~
Autopsy summary: conditions, other, third
Autopsy summary: erythroblastosis fetalis
Autopsy summary: hemorrhaqes, sub~ural or subcapsular
Autopsy summary: hyalfne membrane
Autopsy summary: lun~. atelectasis
Autopsy summary: maceration, ~eoree
Autopsy summary; malformations, lethality
Autopsy summary: ~alformatlons, 1ajor
Autopsy summary: ~alformations, 1inor
Autopsy summary: oetechiae, oth~r than subdurallsubcapsulae
Autopsy summary: oneumonla, other than tnterstltial or viral
Autopsy summary; Pul~onary hemorrhaqe
Autopsy: aqe at death, postnatal
Autopsy: age at death, postnatal
Autopsy: hirth wet~ht
Autopsy: hirth wef~ht Cams)
Autopsy; hrain 1lsposltton
Autopsy; ~iaqnosis, deqree of involvement
Autopsy; ~iaqnosis, 1erived from qross, micro, etc.
Autopsy; ~iaqnosis, derivej from placenta, mother, father, etc.
Autopsy; ~~~qnosls, etiolo~fc, devlattons
Autopsy; ~iAqnosis, etiolo~fc, SNOP
Autopsy; ~iAQnosis, functional, jeviatlons
Autopsy: ~ia~nosls, functional, SNOP
Autopsy: ~iaqnosls, latPrallty
Autopsy: diaqnosis, ~orpholoqtc, deviations
Autopsy: dlaqnosls, ~orPholoqic, SNOP
Autopsy; diaqnosls, sequence number
Autopsy; ~laqnosis, topoqr5Phic, ~eviatlons
Autopsy: ~iagnosis, topographic, SNOP
Autopsy: ~iaqnosis; anatomic, for abortion
Autopsy: edttnr
Autopsy: Pvent type
Autopsy: evPnt, type
Autopsy: oestatfon at bfrt~ (wks)
Autopsy: oestatfon at btrtn (wKs>
Autopsy; hours since death
Autopsy: lab accession number
Autopsy; lab accession numoer
Autopsy: length: crown heel (em>
f"orm Item illumbP.rs linKed to !'lata Items on PATfl-3, llutoosv Protocol
ON
!'lATA
TrF.M
f£1Rio!
Ill
ITt:lo!
H
H
•()
•-.J
II.)
~
I
w
3691.PATH•3
J65Q.PATtt•3
3662.PATH•3
369t.PATH•3
3658.PATH-3
365S.PATH•3
3690.PATH•3
3656.PATH•J
3654.PATH•3
3699.PATH•3
J657.PATH•3
3694.PATH•l
370l.PATH•3
J704.PATH•3
3696.PATH•l
3703.PATH•3
J102.PATH•l
J100.PATH•l
369A.PATH•J
J697.PATH•l
369Q.PATH•l
369S.PATH•l
3707.PATII•l
31oo;.PATH•3
CARO
NliM
2203
1?03
1201
2203
1201
1?03
2201
1?.01
1203
2203
1?.03
2203
2201
2203
2203
2203
2?03
2203
2201
2203
2203
2201
2203
2203
f~OM
H
311
43
30
36
2Q
29
jl')
2A
28
31
40
b2
70
47
b1
64
SA
5?
4Q
55
45
77
74
OAU TTf.M NAME
TCI
15
39
44
12
l1
?9
29
10
28
28
15
44
fil
73
48
69
66
61
'54
'51
57
46
77
74
Autopsy:
Autopsy:
Autopsy:
Autopsy:
Autopsy:
Autopsy:
Autopsy:
Antopsy:
Autopsy:
Autopsy;
Autopsy;
Autopsy:
Autopsy;
Autopsy:
Autopsyr
Autopsy:
Autopsy:
Autopsy:
A11topsy;
Autopsy;
Autopsy;
Autopsy:
State of
WP1Qhts,
length: crown rump (ern)
microscopic done oy
pathologist, co:ier
Placenta, wetqht (Q'IIS)
prosP.ctor
race
race
race, source of infor11atlon
sex
sex
weight at autoPsY (~~s>
weight, !It ~utopsy (qu)
welqhtJ !tdrenals (<~as)
welqht: brain (QIIIS)
wefght; heart (~liS)
weight: leldney, hft ( Q'IS)
weiqht: leldney, rlqht (QIIIS)
weight: liver {QIIIS)
weight: lung, left (QiiS)
welqht; tun~, rtcmt (;:JIIIS)
weight: spleen ( rns)
weight: thY 'IUS (QU)
hody when recelve:i
ho'f recor:te1
DEFINITION OF CODES
.AUTOPSY ?ROTCCOL
P.~-3
CARD 1203
DI.<\GNOSTIC CARD
CARD
COilJMN
1. Card Number
l
Code: · 1
2. Form rTumber
2-4
Code: 203
3· Revision Number
Code:
5
l - Data abstracted from
Auto~sy Re~ort
4. N!NDB Number
Nine-digit number for Patient Identification Code: As given 6-14 5· tab Accessi':n :Jumber
Code: As assigned to s~ecimen in lab.
9999 - Not applicable
WX:OC * - Number assigned by Yakovlev
(Warren Museum)
15-18
6. Tne of Event
Code: l - Abortion, Hydatidiform Mole,
Ectopic Pregnancy
2 - Stillbirth,
fresh
3 - Stillbirth, macerated
4 - Livebirth
19
7-
Weeks of Gestation at Birth
Code: 04-50 - As given
99 - Unknown
20-21
8. Postnatal Age at Death
Code: 00 - Less than 30 minutes
01 - Age 30 minutes-1 hour
02-47 - 2-47 hours
50-78 - 2-30 days (e.g. 50
22-23
=2
days,
76 = 28 days
* X represents
any number
II.C. 73 Reproduced at the National Archives
PA'IH-3
DEFINITION OF CODES
(Continued) FOFM PATH-?
CARD 1203
FIELD CARD
COLUMN
8. Postnatal. ~e at Death (continued)
Code: 80-9- 2-ll miiths (e.g. 80
=2
22-23
months
88 = 10 ::noiiths)
91-96 - 1-6 years
gr - 7 or ::zcre years
98·- Not a~p1icab1e
99 - uiJ.lalcwn
9·
3irth;:.;ei..:ht
Code: As given in grams
9999 10. Sex
COde:
24-27
Unknown
28
0 - Unknown, undetermined
1 - Male 2 - FemaJ.e u. Race
COde: 29
1 - White 2 - Negro 4 - Puerto Rican 8 - Other 9 - Unknown 12. Source of Information of Race
Code: 0 - None , not applicable 1 - Path 3 , page 7, 1tem 15 2 - Other 30
Autonsy
Code: As given in grams. 31-35
~eight ~t
99999 - Unlmown 14. Prosector
See Attachment ''Prosector"
36-37
PATH-3 DEFINITION OF CODES
(Continued)
FOBM PATH-3
CARD 1203
FIELD
CARD
COLUMN
15. Microscopic Done by: See Attachment 11M1croscopic" 38-39
16. Editor See Attachment "Editor" 40-41
17. Brain Disnosition
Code: 1 - Sent to. NINDB
2 - Cut locally
3 - No further examination
4 - No permission
S - Sent to Yakovlev (Warren Museum)
6 - Partial to NINDB
9 - U:cknown
Coder Pathologist
See Attachment 11 Pathologist"
42
19. Anatomic Diagnosis for Abortion
Code: 00 - Not Applicable (Non-Abortion)
01 - Specimen composeu of villi only
02 - Ruptured empty vesicle
03 - Intact empty vesicle
04 - Nodular or cylindrical embryo
05 - Formed fetus with congenital
anomalies: no autopsy done
06 - Formed fetus w1th congenital
anomalies: autopsy done
07 - Stated in PED-4: no pathologic
examination done
08 - Pathologic Examination done
09 - By history only
10 - Ruptured vesicle with cord stump
identified
ll - Cord and placenta, but not fetus ,
available for examination
12 - Specimen composed of decidua only
13 - Embryo identified , but -:m.known whether
normal or abnormal
45-46
20. Diagnosis vas Deri•red from:
Code: 01 - Gross of viscera only
02 - Gross of viscera and summary of
:nicro report
03 - Gross of viscera and full micro
report
47-48
18. II.C. 75
PMH-3
DEFINITION OF CODES
(Continued) FOFM PATH-
CARD J2C3
FIELD
20. 2L
22. 23. CARD
COLUMN
Diagnosis was Derived from: (continued)
47-48
Code: 04 - 3+ gross of brain
05 - 4+ micro of brain
06 - Combination of other than above
07 - Inadequate data (information
fraa PED-4, death certificate,
abstract of protocol., etc.)
08 - Path-l and Psth-2
09 -Not applicable (materna~, sib~ings,
father, rehtive, etc.)
10 - Narrative Path report for abortion
l l - Placenta Diagnosis derived from summary of PATH-3
Diagnosis is That of:
49
Code: l - Offspring 2 - Mother (obstetrical) 3 - Placenta 4 - Siblings 5 -Father 6 - Other relative 7 - Maternal. death
Number Assigned to Diagnosis
50-51
Code: 00:99 - As given
DIAGNOSES
52-71
Topographic Diagnosis ( cols. 52-56)*
Refer to 11 Systematized Ncmencature
of Pstho~ogy" for codes
M?rphologic Diagnosis (cols. 57-61)*
Refer to "Systematized Naaencl.ature
of Pathology" for codes
Etiologic Diagnosis (cola. 62-~
Refer to "Systematized Naaenclature
of Pathology" :f'or codes
Functional Diagnosis (co~s. 67-71~
Refer to "Systematized Nomenclature
of Pathology" :f'or codes
*
201S •
56 , 61
1
66 and n
are blank.
II.C.76
PA'!H-3
DEFINITION OF CODES (Continued)
roRM PATH-3
Card 1203
C.ARD
COLUMN
24.
DEVIATIONS
72-75
Deviation from Tbpogra~hic Dia2nosis (col. 72)
Code: 0 - No deviation
1 - Upgrading of diagnosis
2 - Downgrading of dia.gno sis
3 - Location adjacent to specific organ
Deviation from Mo~holo~ic Diagnosis (col. 73)
Code: 0 - No deviation 1 - Upgrading ':lf diagnosis, :partial 2 - Do'W'Ilgl"ading 0 f di a.gilO sis j with aoo 1 in cola. 56-59 indicates death due to
unlalown cause
3 - Diagnosis unverified by PRB slide review
4 - Remote, by history
5 - Diagnosiiic variance based on PRB
slide review
Deviation from Etiolo~ic Diagnosis
(col. 74)
Code: 0 - No deviation 1 - Upgrading of diagnosis, ~artial 2 - Downgrading of diagnosis 4 - Remote, by hi~~ry Deviation from Functional Diagnosis (col. 75)
Code: 0 - No deviation
1 - Upgrading of diagnosis, :partial
2 - Downgrading of diagnosis
3 - Diagnosis unverified by PRB slide review
4 - Re:mte, by history
5 - Diagnosis variance based on PRB
slide reviev
25.
Degree of Involvement Code: 0 - Unspecified 1 - Slight 2 - Moderate 3 - Severe or marked 4 - Nbt applicable 76
26.
laterality
Code: 0 - Unspecified 1 - Right 2 - Left 3 - Bilateral 4 - Not applicable 71
IDTE: A card is punched for each diagnosis.
repeated on each card.
II.C. 77 Card cola. 1-46 are
PA'm-3
DEFTIITTION OF CODES (Continued) FOFM PATH-3
TflEIGRT C.AF.D
CARD 2203
FIELD CARD
COIIJMN
l. Card Number
1
Code: 2
2. Basic Data
2-29
Same as in cols. 2-29 of Card 1
3·
4.
Placenta Weight Code: As given in grams
998 - 998 grams and over
999 - Unknown, not available
Crown-R~
Length 30-32
33-35
Code: As given to tenths of em.
989 - 98.9 ems • and aver
999 - Unknown
5·
Cro•Nn-Eeel Length Code: As given to tenths of em..
36-39
Body Weight at Autopsy
4o-44
9989 - 998.9 ems. and aver
9999 - Unla1own
6. Code: As given in grams 99999 -
7-
(]nknown Thymus Wei.~Iht Code: As given· in grams 00 - UIJder 0. 5 grams 45-46
98 - 98 grams or aver 99 -Unknown 8. Heart
~.J'ei.>tht
Code: As given
i~
47-48
grams
CO ~ Under 0.5 gr~rs,
98 - 98 grems :lr mre
99 - Unkl:l;:)wn
~~mbined N~t~ ~'~gs
PA'lll-3
DE!i'llUTION OF CODES (Continued) FOFM PAm-3
WEIGHT CARD
CARD 22C3
CARD
COIIJMN
9·
for
Lururs and or Eeart
Code: As given 1n gxoams
000 - Under 0.5 grams
998 - 998 grams or more
999-
10.
Unknmm
Left Lung Weight
Code: As given in gTams
000 - Combined with right lung
and/or heart, under 0. 5 grams
998 - 998 grams or over
999 -
ll.
Spleen Weight
000 - Under 0. 5 grams
Liver
Code:
Weight
As given in grams
0000 - Under 0. 5 grams .
14.
15.
64-66
Unk:nmm
Left Kidney Weight
Code: As given in. gz""l"1S
000 - Combined with right kidney, under
0.5 grams
998 - 998 grams
999 - Unknown
67-69
or over
II.C. 79
62-63
Unk:nmm
Right Kidney Weight or Combined Kidney T.¥eight
000 - Under 0 • 5 grams
999 -
58-61
Unk:nmm
Adrenals Weight
Code: As given in gi""'...J:IlS
00 - Under 0. 5 grams
99 -
55-57
Unknow.
9999 13.
52-54
Unknow.
999 -
12.
49-51
PA'!B-3
.SEF:C~ICN 0?
CODES (Continued.)
FORM PA::H-3
WEIGHT CAF.D
Card. 2203
FIELD
16. CARD
COIDMN
Brain. Weight
Cod.e: As given. in grams 0000 - Under 0.5 grams 9998 - 9998 grams or over 9999 -
17. 70-73
Unknown now Weights Were Recorded
Code: 1 - All paired organs weighed
separate~ except adrenals
2 - Lungs combined
3 - Kidneys combined
4 - Heart and lungs combined
6 - Lungs combined 'With organs other
than heart
7 - Conbination o'Z codes 3 s.nd 4
8 - Other organ combination
9 -Unknown
18. Int~ra1 From Death to Autopsy in Hours
Code: 00 - Less than one hour in-96 - As given in hours 97 - 97 hours ar over. 98 - Uot applicable T5-76
99 -Unknown 19. State of Body When Received for Autopsy
Code: 1 - Unspecified, un:f'ixed or unknown 2 - Fixed or in fixative solution 3 - All organs unfixed except brain II.C.80 Reproduced at the National Archives
77
PA'IH-3
DEFINITION OF CODES
(Continued) FORM PATH-3
'
JFFSPRDTG DIA.GlTC. __ .:3
Card 4203
CABD
COIIJMN
FIELD
1. Card Number
Code: 4
l
2. Form Number
Code: 203
2-4
3-
Revision Number
Code: l - Data Abstracted from autopsy
report
5
4. NIND:S Number
Nine-digit number for Patient Identification
Code: As given
6-14
5.
Degree of Maceration Code: 0 - Not applicable l - Slight 2 - Moderate 3 - Severe 4 - Present but degree unknown 15
6. Congenital Malformations
Lethality
(col. 16)
Code: 0 - None
l - Non-lethal 2 - Lethal 16-18
MaJor Malformation~ (col.
Minor Malformations (col.
Code for each column: 0 l 2 -
7-
17) l.8) None Single syAtem
Multiple systems
Hyaline Membrane Code: 0 - None l - Slight 2 - Moderate 3 - Present but degree unknown II.C.Bl Reproduced at the National Archives
19
PA'IH-3
DEFINITION OF CODES
(Continued)
FORM PAT.:!- 3
OFFSPRI:TG DLA.G:TOSIS
Card 4203
CARD
COLUMN
8. Pneumonia: Other than Interstitial or Viral
Code: Same as in Field 7 20 9· Erythroblastosis Fetalis
Code: 0 - None 1 - Present but not otherwise
2 - Hydrops 2l
s~eci~ied 10. Atelectasis
22
n. Pulmonary Hemorrhage
23
12. Petechiae:
Code: 0
1
2
3
-
4 -
513. 14. Other than Sub-Dural or
Sub-Ca"Osular
None S1ng.le organ Multiple organs Sub-arachanoid or intra-ventricular hemorrhage
Combination of codes 1 and 3
Combination o~ codes 2 and 3
Hemorrhae;es: Sub-Dural or Sub-Ca"Osular
Code: 0 - None 1 - Sub-capsular only 2 - Sub-dural only 3 - Combination of codes 1 and 2 4 - Extra-dural. only 5 - Combination of codes 1 and 4 6 - Combination of codes 2 and 4 7 - Combination of codes 1, 2, and
Other Conditions
Six-digit code for:
First Condition
(cols. 26-27)
Second Condition
(cols. 28-29)
Third Condition
(eels. 30-31)
See attachment "O:t'fspring Diagnoses" page PATH-3-18 II.C.82 Reproduced at the National Archives
25
I
l.j.
26-31
PA'm-3
Codes for Prosector; Micro by;
Editor; and Pathcrlgy, By Hospital
.;sditors
Hos:Eital - 05
01 La.ten
26 27
28 29 30 31 02
03 o4 05 o6 01 08 Dekker
Johnson
Bha.ktaviziam
Fanning
El Massry
Goldstein
32 Haran
33 Fox
34 Brown
35 Savena
36 Barton
31 Miranda
38 Quan
39 McCombs
40 Grover
41 Garcila.go
42 Joekin
43 Jasemovich
44 Sullivan
45 Bradford
46 de Nenicia
47 Nassiri
48 Devine
49 Hajj
50 Lauro
51 Driscoll
52 ·Shapiro
53 Fess
54 Frederick
Grunberg
Fletcher
Gordon
Laskey
Meyers
Froehlich
Greenfield
Coder - Patholosists 01 Froehlich
02 Fujikura
03 Valsamis
Prosector - MicroscoEic
HosEital - 05
00 Medical Examiner
01 Witzleben 02
Diamandopolulos
03 Nasongkhla
o4 Takuchi
05 Vawter
o6 Branch
07 Singer 08 Craig
09 Wiebanks
10 Safon
ll Haim
12 Beernich 13 Massad
14 Cooper 15 Feldlila.n
J.6 Richart
17 Gochberg
1.8 Yassin 19 Martin
20 Ellington
21 Beglin
22 Potter
23 Broderick
24 Raslavicus
25 Griffiths
55
56 57
58
59
6o
61 62
63 64
65
Sharp
Ross
Benerschke
Farber
Dickerson
Brochin
Davidson
Ring
Sander
Soma Stauf'f'er
66 Smith
67 Cohen
~cent.)
PA'Jli-3
Prosector- Microsco~ic
(cont.)
Hospital- 10 rcont. 1
13 Bazavgan
14 Robinson
15 :::..o:p.ez
97 ~on Study Pathologis0
98 Micro ~ot Done
Hos~ital - 15
Hosuital- 05 (cont.)
68 Aires
69 .Uvardo
70 Fung
71 ."lechanic
72 Paci
73 Deligiorgi
;4 Favara
75 Santos
76 Seradj
77 Parthenis
78 Leonidas
79 Rodriques
80 Hedley
81 0' Halloran
82 Edlow
83 King
84 Allen
85 Sato
86 Shen
87 Rananuvare
88 s-;ol'anson
89 Laga
90 '.falonf
91 C'hoi
92 ?reeman
9~ Tegtmeyer 9L. Davt 00
01
02
03
04
05
06
07
08
09
10
ll
l2
13
14
15
16
17
18
19
20
21
95 Suh 96 Other, not elsewhere specified
97 Non-Study Pathologist
98 Micro Not Done
22
23
24
97
98
Medical Examiner
Bergeron
Dent
Burch
Gilmer
Stern
Halthous
Foley
Rosal
Sculley
Sternberg
Froehlich
Elliott
Welch
Smilow
Smith
Samuels
Henderson
Holcomb
Medauar
Simpson
Frater
Reed
White
Trueting
Non-Study Pathologist
Micro ~ot Done
Hospital -
~1
X
00 Medical Examiner Ol Miller 02 Beans 03 Blanc 04 Chlebus 05 Kauffman o6 Devlin 07 Ores o8 ::-Tavarro 09 Rutgers 10 LeYy l l Malcolmson 12 Truscott 13 Perrin 14 CUshman 15 Dische 16 Boyer Hos-oi tal - 10
00 Medical Examiner 01 O'Sullivan 02 Terplan o~
.J
Froehlich
04 Legnami 05 Lohoczky 06 Aterman 07 Harrod 08 Lukas 09 Tongco 10 Abaci u Kazi 12 Fiero II.C.84
PA'IH-3
Prosector - >licrosco-oic (cant.)
HoSPital- 31 (cont.)
Hos-oital- 37 (cont.)
17 Eeatrice
18 :Corsicsky
19 Glenn
20 Tovall
21. Janovski
22 Flaxman
23 Dunn
24 Kelly
25 Weir
26 Anderson
27 Godd
28 Gates
29 Froehlich
30 Bowyer
31 Perzin
32 Blechner
33 King
34 Chenault
98 Micro Not Done
30 Johnson
31 0 r Q::.inn
32 Harper
33 Nicholson
34 Garrett
35 Wilson
36 Wilkinson
37 Leiby
38 Merrill
39 Gregg
40 Gray
41 Richmond
42 Elliott
43 Patchefsk:r
44 Hartman
45 Christian
46 Eggleston
47 !'Teill
48 Ta.nn
49 Le•rine
98 Micro Not Done
Hostlital - 37
00 Medical Examiner
HoSPital - 45
00 Medical Examiner
01 Ishisaki
02 Madge
03 Calle
04 Belter
05 Bates
o6 Ha.nsbarger
07 Rose
08 Diggs
09 Goodwin
10 Friedrich
ll Clark
12 Richart
13 Donahue
14 Graham
15 Repass
16 Burton
17 Lardizabal
18 Richa.ny
19 Seavice
20 Burkhart
21 Nakoneczna
22 Dav·is
23 Smith
24 Daly
25 Thomas
26 Froehlich
27 Eain
28 Rogers
01 Erown
02 Gruenwald
03 rrost
04 Pusch
05 Sutton
06 Tseng
07 Boitnott
08 Nicastri
09 Jordan
10 Ha.nnil'.al
11 Norton
12 Sha.nb
13 O'Toole
14 Baens
15 Linthicum
16 Shelley
17 Carter
18
Berman
19 Clowry
20
21.
22
23
24
25
26
27
28
29
Esterly
Lee
Porro
Robson
Lane
Haghighi
Wheeler
Patterson
Hutchins
Pappas
II.C.85
PA'IH-3 Prosector - ~1icroscopic ( cont)
Hosoital- 45 (cont.)
29 Elswick
30 E'ra.ns
31 ·.~nite
32 Keely
98 Micro Not Done
Hospital - 60
00 Medical Examiner
01 Cafaro
02 Emig
03 Hunter
04 Fuj ik.ura
05 Sweeny
06 Little
07 Long
08 Lehman
09 Smith
10 Clare
11 Gelsey
12 Castro
13 Joshi
14 Vinyard
15 ?rice
16 Graham
17 Lipkin
18 Froehlich
19 Philip
20 Strunk
21 Larson
22 Gourley
23 Paff
24 Hirons
25 Sawyer
26 Thomas
27 Walker
28 Crisera
29 Rippey
30 Odell
31 Abed
32 Malison
33 Koehler
34 Hoskins
35 Evans
36 Lee
37 Lehfeldt
38 Horn
98 Micro Not Done
Hospital - 50
00 Medical ExamL~er
01 Fattah
02 Herm
03 Burke
04 Lufkin
05 Hella.n
06 Herdman
07 Guthrie
08 Eggen
09 Coe
10 Swallen
11 McKelvey
12 Froehlich
13 Golden
14 Woodburn
15 Osterberg
16 Cohen
17 Sauls
18 Gilsdorf
19 Blau
98 Micro Not Done
Hospital - 55
00 Medical Examiner
01 lli.ller
02 Salo
03 Kim
04 di Blasi
05 Shenoy
06 Cohen
07 Khan
08 Urdaneta
09 Altman
10 Domingo
11 Kish
12 Akhavan
13 Solidum
14 Mallouh
15 Froehlich
98 i.ficro ~ot Done
II.C.86
PATH-3
Prosector- Microsco~ic
(cont.)
Hos"Cital - 66
Hos~i tal
00 Medical Examiner
01 Baker
44 Tenaztepe
02
03
04
05
o6
07
08
09
10
ll
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
(cont.)
45 Siegler
46 Lewis
47 Meyers
Chatten
McConaghie
Yakovac
Colston
Knayer
Eriksen
Amurao
Frederick
Piampiti
Spelman
Pendleton
Fillinger
Ka.nari
Scarano
Dapena
Schiller
Weston
Muniz
Sharpe
Isaacs
Lerner
Ziel Mc(}au.ghey
Pappou
Gonzalez
Campbell
Aronson
Seidel
Vakil
Mikat
Sa. lim
Weidman
Schultze
Viola
Beatty Hausman La.hoda Zacks Crane Rose Decker Olen 48 Lee
49 O'Brien
50 Whitely
51 Helsel
52 Longo
53 Currie·
54 Lubin
55 Peck
56 Arden
57 Eisinger
58 Linsk
59 Elton
60 Francis
61 Gillespy
62 Froehlich
63 Sta.nitcki
64 Lipkin
65 Scott
97 Nsn-Study Pathologist
98 Micro Not Done
Ho~ital - 71
00 Medical Examiner
01 Anderson 02
03
04
05
06
07
08
09
97
98
II.C.87
- 66
Song
Freeman
Greene Deddoe Mold
Robinson
Seibert
Froehlich
Non-Study Pathologist
Micro Not Done PA'IH-3
Prosec~or-
Microscopic
(cont.)
Hos"Oital - 82
00 Medical Examiner
01 Johnson
02 Sprunt
03 Francisco
04 Essman
05 Fuste
06 Iglesias
07 Duckworth
08 Martinez
09 Coleman
10 CrRcker
ll
Ye:r.ea
98 Micro ~Tot Done
II.C.88
PA'IH-3
OFFSPRING DIAGNOSES Code
Infections
01
Meningitis
02
Septicemia
03
Interstitial Pneumonia
o4
Herpes
05
Peritonitis other than
meconium peritonitis
o6
Aspiration Pneumonia
07
Omphalitis
08
Cellulitis
09
Rheumatic Heart Disease
10
Infections NOS
Metabolic, Familial and Other Disorders
50
Glycogen Storage Disease
51
Glycogenesis
52
Dysgamma globulinemia
53
Fibrocystic Disease
54
Waterhouse - Friederichsen
55
Wolf Parkinson White Syndrome
56
Werdnig - Hoffman
57
Riley - Day Syndrome
Mechanical Abnormality
60
Thrombosis, Vein of Galen
61
Thrombosis, lungs
62
Thrombosis, organs other
than lungs
63
Edema.
64
Pneumothorax
65
Aspiration, NOS
66
Bleeding duodenal ulcer
67
Meconium peritonitis
68
Dehydration
69
Kernicterus
70
Sudden Unexplainable Dea
71
Meconium Staining, skin
72
Post operative State
73
Exchange transfusion
74
Intrauterine transfUsion
Injuries
20
Traumatic NOS
21
Possible Birth Injury
22
Laceration, Vein of Galen
23
Tentorial Tear
24
Fracture, Extremity
25
Fracture, Skull
26
Fracture, Spine
27
Accidental Deaths
28
Lead Poisoning
Anemias
30
31
32
33
34
35
36
37
38
39
Tumors
40
41
42
43
44
45
47
L.8
4o
Sickle Cell
Polycythemia
Hemophilia
Methemoglobinemia
98
Letterer - Siwe
00
Spher9cytosis congenital
Anemia NOS
ABO Incomnatibility
Deficiency Factor V and VII
G6PD deficiencies and other specific anemias
Other abnormalities
No abnormalities
Neuroblastoma
Hepatoma
Wilm' s Tumor
Leukemia NOS
Medulloblastoma.
Astroblastoma.
Neurofibroma.
Hemangiol!lS. of liver or
spleen or lung
Granu1osa cell tumor of testis
II.C.89
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PATH-3

Document 6426062

Transcription

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