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 - Number of Prenatal Visits

Official URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-number-prenatal-visits Version: 2.0.0
Active as of 2025-02-19 Computable Name: ObservationNumberPrenatalVisits
Other Identifiers: OID:2.16.840.1.113883.4.642.40.13.42.73

The total number of prenatal visits for the mother. The dates of the first and last prenatal visit are indicated by the effective date range. If the mother received no prenatal care, the value should indicate 0 visits.

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 132 Total Number of Prenatal Care Visits NPREV value integer
Natality 133 Total Number of Prenatal Care Visits--Edit Flag NPREV_BYPASS value.extension[bypassEditFlag].value codeable PregnancyReportEditFlagsVS,
See Handling of edit flags 

Form Mapping

Form Mapping
Item # Form Field FHIR Profile Field Reference
30 Total Number Of Prenatal Visits For This Pregnancy value Certificate of Live Birth
7 Total number of prenatal care visits for this pregnancy value Facility Worksheet for the Live Birth Certificate
24 Total Number of Prenatal Visits For This Pregnancy value 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: 68493-6
... subject Σ 1..1 Reference(Patient - Mother Vital Records) Who and/or what the observation is about
ele-1: All FHIR elements must have a @value or children
... effective[x] Σ 0..1 dateTime Clinically relevant time/time-period for observation
ele-1: All FHIR elements must have a @value or children
... value[x] ΣC 1..1 integer Actual result
ele-1: All FHIR elements must have a @value or children
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... 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 pregnancy report of Education, Mother's height, Mother's pre-pregnancy weight and Prenatal care visit number and also to reflect the relevant edit possibilities for pregnancy status of Female decedent.
Binding: Pregnancy Report Edit Flags (NCHS) (required): Pregnancy Report Edit Flags (NCHS)


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 68493-6
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Observation.value[x].extension:bypassEditFlag.value[x]requiredPregnancyReportEditFlagsVS
http://hl7.org/fhir/us/bfdr/ValueSet/ValueSet-pregnancy-report-edit-flags
from this IG

 

Other representations of profile: CSV, Excel, Schematron