The pathological study of the placenta is of upmost importance in cases of unexplained fetal/perinatal loss and often these carry litigation implications. Integrating pathological findings and the underlying pathophysiological processes, leading to placental lesions, is fundamental for the evaluation of poor fetal and perinatal outcomes and to distinguish from cases of true negligence.Keywords: Placenta; Litigation process; Pathology study; Histopathology Overall PerspectiveUnderstanding the placental function has been crucial for a clinical and well-founded interpretation of pathological alterations associated with poor obstetric outcomes. The anatomopathological study of the placenta allows the investigation of unforeseen cases of fetal/perinatal loss, while further developing our knowledge of some neonatal diseases. The significance of this study is even greater if one considers that about 3/1,000 children will suffer of some sort of cerebral palsy [1][2][3][4]. The increase of litigation processes towards hospitals and obstetricians is a reality and in most cases, the litigant part claims negligence. Setting aside, well documented cases of true negligence, one must consciously and responsibly select cases with pathology associated with a poor obstetric outcome. For this purpose, the study of the placental is fundamental [5]. It is important to note that, the aim of this article is not to describe any epidemiological study of specific cases of placental disorders but, to emphasize that the study of the placenta may reveal undiagnosed or unsuspected pathologies in cases of poor obstetric outcomes that explains and justifies fetal/perinatal loss. Placental pathological features and adverse fetal outcomeImplantation anomalies can lead to velamentous cord insertion with or without vasa previa, to placental accrete and/or to placenta previa and it is well documented its relationship with neurological damage and increased risk of fetal loss [6,7].Placental infarction is a pathological condition of unknown etiology with distinctive features and has been associated with fetal intrauterine growth retardation (IUGR), microcephaly and neurological complications [1,8].Decidual arteriopathy is a type of injury diagnosed only histologically and usually occurs as result of maternal circulatory disorders, such as pre-eclampsia, hypertension, antiphospholipidic syndrome and thrombophilia. It is also associated with placental poor perfusion and low weight, leading to IUGR [6,9]. The period of time that, placental lesions take to evolve and extend, and how they become installed are determining factors for fetal complications. The most common example is the abrupt placenta, a serious condition in which, the time period taken to develop a retroplacental hematoma is crucial for the macroscopic interpretation of the lesion and is critical to understand fetal complications. When fetal death does not occur, neurological damage is usually frequent [2,3]. Similarly, placental infarctions have consequent fetal complications acco...