Awareness of Placental Pathologic Examination Criteria and Utilization of Pathology Reports among Obstetricians.

Background and Objectives: Several studies have reported a low rate of pathological examination of the placentas and a poor utilization of pathology reports. We assessed Saudi obstetricians' awareness and utilization of the placental pathological examination guidelines of the College of American Pathologists (CAP) and evaluated their understanding of the reports. Materials and Methods: An anonymous survey was distributed to obstetricians registered in the Saudi Commission of Health Specialties database. We examined the association between the participants' level of training or practice as well as their institution type with the surveyed elements. Results: Of 292 respondents, 34.2% were aware of the CAP guidelines. Most of them were practicing in government hospitals. Moreover, 18.2% of them routinely sent the placenta for pathological examination, and approximately 70.5% routinely reviewed the pathology reports and understood the nomenclature used; these percentages were significantly higher among university hospital practitioners. The residents were the least aware of the CAP guidelines and the least likely to review and understand the pathology reports. Regardless of the CAP guidelines awareness, the most common indication for placental pathologic examination was fetal anomalies, followed by medicolegal reasons and infections. Conclusions: Placental pathologic examination appeared uniformly underutilized in Saudi Arabia. Obstetricians are required to generate awareness of the need to comply with the CAP guidelines and to improve the understanding and utilization of pathology reports.

Homicide in Relation to Mental Illness: Stigma Versus Reality.

This narrative review examines different aspects of homicide among mentally ill individuals to compare the rates of homicide by offenders with and without mental illness and investigate the stigma of mental illness and its consequences. It also evaluates the motives of mentally ill perpetrators and their characteristics and explores weapons of choice in homicides related to different mental disorders. Studies confirmed higher homicide rates among specific categories of mentally ill individuals who experienced maltreatment, unemployment, abuse in childhood, and substance abuse resulting from stigma and discrimination. The motives were mainly revenge, argument, financial gain, sexuality, sadism, and filicide, with revenge being the top motive. Offenders were found to have close relationships with their victims in most cases. Sharp instruments were the most commonly used weapons. Our review confirms the lack of evidence linking mental illness independently with homicide, both globally and in Arab countries, and highlights the impact of discrimination toward mentally ill individuals. This discrimination and stigma lead to delayed care-seeking and self-destructive behavior, which is linked to higher homicide rates among persons with and without mental illness.