Birth And Fetal Death (BFDR) FHIR Implementation Guide
2.0.0 - STU2  flag

Birth And Fetal Death (BFDR) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-bfdr/ and changes regularly. See the Directory of published versions

Resource Profile: Observation - Gestational Age at Delivery

Official URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-gestational-age-at-delivery Version: 2.0.0
Active as of 2025-02-19 Computable Name: ObservationGestationalAgeAtDelivery
Other Identifiers: OID:2.16.840.1.113883.4.642.40.13.42.48

The obstetric estimate of the infant’s gestation in completed weeks based on the birth/delivery attendant’s final estimate of gestation which should be determined by all perinatal factors and assessments such as ultrasound, but not the neonatal exam. For submission to NCHS, values in days will be divided by 7 without remainder, and values in weeks will be rounded down to an integer.

The edit flag extension supports validation as part of the Jurisdiction to NCHS use case and can be ingnored for the provider to jurisdiction use case. The validation checks are done at the jurisdiction prior to sending to the National Statistical Agency and are based on the item specific edit criteria specified in the Birth Edit Specifications for the 2003 Proposed Revision of the U.S. Standard Certificate of Birth and the Fetal Death Edit Specifications for the 2003 Revision of the U.S. Standard Report of Fetal Death.

IJE Mapping

Natality
Use Case # Description IJE Name Field Type Value Set/Comments
Natality 203 Obstetric Estimation of Gestation OWGEST value quantity value is a decimal; unit is from UnitsOfGestationalAgeVS
Natality 204 Obstetric Estimation of Gestation--Edit Flag OWGEST_BYPASS value.extension[bypassEditFlag].value codeable EstimateOfGestationEditFlagsVS,
See Handling of edit flags 

Fetal Death
Use Case # Description IJE Name Field Type Value Set/Comments
Fetal Death 145 Obstetric Estimation of Gestation OWGEST value quantity value is a decimal; unit is from UnitsOfGestationalAgeVS
Fetal Death 146 Obstetric Estimation of Gestation--Edit Flag OWGEST_BYPASS value.extension[bypassEditFlag].value codeable EstimateOfGestationEditFlagsVS,
See Handling of edit flags 

Form Mapping

Form Mapping
Item # Form Field FHIR Profile Field Reference
50 Obstetric Estimate of Gestation value Certificate of Live Birth
30 Obstetric estimate of gestation at delivery value Facility Worksheet for the Live Birth Certificate
30 Obstetric estimate of gestation at delivery value Attachment to the Facility Worksheet for the Live Birth Certificate for Multiple Births
18d Obstetric Estimate of Gestation at Delivery value Report of Fetal Death
20 Obstetric estimate of gestation at delivery value Facility Worksheet for the Report of Fetal Death

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C 0..* Observation Measurements and simple assertions
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.


ele-1: All FHIR elements must have a @value or children
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 11884-4
... subject Σ 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children
... value[x] ΣC 1..1 Quantity Age in weeks or days
ele-1: All FHIR elements must have a @value or children
.... Slices for extension Content/Rules for all slices
..... bypassEditFlag 0..1 (Complex) BypassEditFlag Vital Records
URL: http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... extension 0..0
...... url 1..1 uri "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag"
...... value[x] 1..1 CodeableConcept To reflect the relevant edit possibilities for estimate of gestation.
Binding: Estimate of Gestation Edit Flags (NCHS) (required): Estimate Of Gestation Edit Flags (NCHS)


ele-1: All FHIR elements must have a @value or children
.... value Σ 1..1 decimal Numerical value (with implicit precision)
ele-1: All FHIR elements must have a @value or children
.... comparator ?!Σ 0..1 code < | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.


ele-1: All FHIR elements must have a @value or children
.... code Σ 0..1 code Coded form of the unit
Binding: Units of Gestational Age (required)
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Observation.statusrequiredObservationStatus
http://hl7.org/fhir/ValueSet/observation-status|4.0.1
from the FHIR Standard
Observation.codeexamplePattern: LOINC Code 11884-4
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x].extension:bypassEditFlag.value[x]requiredEstimateOfGestationEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-estimate-of-gestation-edit-flags
from this IG
Observation.value[x].comparatorrequiredQuantityComparator
http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1
from the FHIR Standard
Observation.value[x].coderequiredUnitsOfGestationalAgeVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-units-of-gestational-age
from this IG

 

Other representations of profile: CSV, Excel, Schematron