Birth And Fetal Death (BFDR) FHIR Implementation Guide
2.0.0 - STU2 - CIBuild United States of America 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 - Fetal Presentation at Birth/Delivery

Official URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-fetal-presentation Version: 2.0.0
Standards status: Draft Computable Name: ObservationFetalPresentation
Other Identifiers: OID:2.16.840.1.113883.4.642.40.13.42.46

This Observation profile represents the fetal presentation (orientation within the mother's womb) of a fetus prior to delivery/birth. Only the presentations in the preferred binding can be reported to NCHS. The full set of abnormal presentations is included to support more general use.

IJE Mapping

Natality
Use Case # Description IJE Name Field Type Value Set/Comments
Natality 192 Method of Delivery--Fetal Presentation PRES value codeable FetalPresentationsVS

Fetal Death
Use Case # Description IJE Name Field Type Value Set/Comments
Fetal Death 133 Method of Delivery--Fetal Presentation PRES value codeable FetalPresentationsVS

Form Mapping

Form Mapping
Item # Form Field FHIR Profile Field Reference
46.C Fetal presentation at birth value Certificate of Live Birth
27.C Method of delivery: Fetal presentation at birth value Facility Worksheet for the Live Birth Certificate
27.C Method of delivery: Fetal presentation at birth value Attachment to the Facility Worksheet for the Live Birth Certificate for Multiple Births
38.C Method of Delivery: Fetal presentation at delivery value Report of Fetal Death
17.A Method of Delivery: Fetal presentation at delivery value Facility Worksheet for the Report of Fetal Death

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.status This element is a modifier element. This element is included in summaries. 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.code This element is included in summaries. 1..1 CodeableConcept Fetal presentation at birth/delivery
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "73761-9"
    }
  ]
}
Observation.subject This element is included in summaries. 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
Observation.value[x] This element is included in summaries. C 1..1 CodeableConcept The preferred value set contains the list of reportable presentations (orientations within the mother's womb) that a fetus may be in prior to delivery.
Binding: Fetal Presentations (preferred)
Additional BindingsPurpose
Fetal Presentations - Max Max Binding

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x] Base preferred Fetal Presentations 📦2.0.0 This IG

Constraints

Id Grade Path(s) Description Expression

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation 0..* Observation Measurements and simple assertions
Observation.code 1..1 CodeableConcept Fetal presentation at birth/delivery
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "73761-9"
    }
  ]
}
Observation.subject 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
Observation.value[x] 1..1 CodeableConcept The preferred value set contains the list of reportable presentations (orientations within the mother's womb) that a fetus may be in prior to delivery.
Binding: Fetal Presentations (preferred)
Additional BindingsPurpose
Fetal Presentations - Max Max Binding

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x] Base preferred Fetal Presentations 📦2.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
Observation.id This element is included in summaries. 0..1 id Logical id of this artifact
Observation.meta This element is included in summaries. 0..1 Meta Metadata about the resource
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
Observation.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Observation.contained 0..* Resource Contained, inline Resources
Observation.extension 0..* Extension Additional content defined by implementations
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.identifier This element is included in summaries. 0..* Identifier Business Identifier for observation
Observation.basedOn This element is included in summaries. 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Observation.partOf This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
Observation.status This element is a modifier element. This element is included in summaries. 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Observation.code This element is included in summaries. 1..1 CodeableConcept Fetal presentation at birth/delivery
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "73761-9"
    }
  ]
}
Observation.subject This element is included in summaries. 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
Observation.focus This element is included in summaries. 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Observation.encounter This element is included in summaries. 0..1 Reference(Encounter) Healthcare event during which this observation is made
Observation.effective[x] This element is included in summaries. 0..1 Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime dateTime
Observation.effective[x].effectivePeriod Period
Observation.effective[x].effectiveTiming Timing
Observation.effective[x].effectiveInstant instant
Observation.issued This element is included in summaries. 0..1 instant Date/Time this version was made available
Observation.performer This element is included in summaries. 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
Observation.value[x] This element is included in summaries. C 1..1 CodeableConcept The preferred value set contains the list of reportable presentations (orientations within the mother's womb) that a fetus may be in prior to delivery.
Binding: Fetal Presentations (preferred)
Additional BindingsPurpose
Fetal Presentations - Max Max Binding
Observation.dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.note 0..* Annotation Comments about the observation
Observation.bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen 0..1 Reference(Specimen) Specimen used for this observation
Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
Observation.referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
Observation.referenceRange.id 0..1 string Unique id for inter-element referencing
Observation.referenceRange.extension 0..* Extension Additional content defined by implementations
Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
Constraints: sqty-1
Observation.referenceRange.high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
Constraints: sqty-1
Observation.referenceRange.type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age 0..1 Range Applicable age range, if relevant
Observation.referenceRange.text 0..1 string Text based reference range in an observation
Observation.hasMember This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
Observation.derivedFrom This element is included in summaries. 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
Observation.component This element is included in summaries. 0..* BackboneElement Component results
Observation.component.id 0..1 string Unique id for inter-element referencing
Observation.component.extension 0..* Extension Additional content defined by implementations
Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.component.code This element is included in summaries. 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x] This element is included in summaries. 0..1 Actual component result
Observation.component.value[x].valueQuantity Quantity
Observation.component.value[x].valueCodeableConcept CodeableConcept
Observation.component.value[x].valueString string
Observation.component.value[x].valueBoolean boolean
Observation.component.value[x].valueInteger integer
Observation.component.value[x].valueRange Range
Observation.component.value[x].valueRatio Ratio
Observation.component.value[x].valueSampledData SampledData
Observation.component.value[x].valueTime time
Observation.component.value[x].valueDateTime dateTime
Observation.component.value[x].valuePeriod Period
Observation.component.dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x] Base preferred Fetal Presentations 📦2.0.0 This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.status This element is a modifier element. This element is included in summaries. 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.code This element is included in summaries. 1..1 CodeableConcept Fetal presentation at birth/delivery
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "73761-9"
    }
  ]
}
Observation.subject This element is included in summaries. 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
Observation.value[x] This element is included in summaries. C 1..1 CodeableConcept The preferred value set contains the list of reportable presentations (orientations within the mother's womb) that a fetus may be in prior to delivery.
Binding: Fetal Presentations (preferred)
Additional BindingsPurpose
Fetal Presentations - Max Max Binding

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x] Base preferred Fetal Presentations 📦2.0.0 This IG

Constraints

Id Grade Path(s) Description Expression

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation 0..* Observation Measurements and simple assertions
Observation.code 1..1 CodeableConcept Fetal presentation at birth/delivery
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "73761-9"
    }
  ]
}
Observation.subject 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
Observation.value[x] 1..1 CodeableConcept The preferred value set contains the list of reportable presentations (orientations within the mother's womb) that a fetus may be in prior to delivery.
Binding: Fetal Presentations (preferred)
Additional BindingsPurpose
Fetal Presentations - Max Max Binding

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x] Base preferred Fetal Presentations 📦2.0.0 This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
Observation.id This element is included in summaries. 0..1 id Logical id of this artifact
Observation.meta This element is included in summaries. 0..1 Meta Metadata about the resource
Observation.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
Observation.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
Observation.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Observation.contained 0..* Resource Contained, inline Resources
Observation.extension 0..* Extension Additional content defined by implementations
Observation.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
Observation.identifier This element is included in summaries. 0..* Identifier Business Identifier for observation
Observation.basedOn This element is included in summaries. 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Observation.partOf This element is included in summaries. 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
Observation.status This element is a modifier element. This element is included in summaries. 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Observation.category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
Observation.code This element is included in summaries. 1..1 CodeableConcept Fetal presentation at birth/delivery
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Required Pattern: 
{
  "coding" : [
    {
      "system" : "http://loinc.org",
      "code" : "73761-9"
    }
  ]
}
Observation.subject This element is included in summaries. 1..1 Reference(Patient - Child Vital Records | Patient - Decedent Fetus) Who and/or what the observation is about
Observation.focus This element is included in summaries. 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Observation.encounter This element is included in summaries. 0..1 Reference(Encounter) Healthcare event during which this observation is made
Observation.effective[x] This element is included in summaries. 0..1 Clinically relevant time/time-period for observation
Observation.effective[x].effectiveDateTime dateTime
Observation.effective[x].effectivePeriod Period
Observation.effective[x].effectiveTiming Timing
Observation.effective[x].effectiveInstant instant
Observation.issued This element is included in summaries. 0..1 instant Date/Time this version was made available
Observation.performer This element is included in summaries. 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
Observation.value[x] This element is included in summaries. C 1..1 CodeableConcept The preferred value set contains the list of reportable presentations (orientations within the mother's womb) that a fetus may be in prior to delivery.
Binding: Fetal Presentations (preferred)
Additional BindingsPurpose
Fetal Presentations - Max Max Binding
Observation.dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.note 0..* Annotation Comments about the observation
Observation.bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Observation.method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
Observation.specimen 0..1 Reference(Specimen) Specimen used for this observation
Observation.device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
Observation.referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
Observation.referenceRange.id 0..1 string Unique id for inter-element referencing
Observation.referenceRange.extension 0..* Extension Additional content defined by implementations
Observation.referenceRange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.referenceRange.low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
Constraints: sqty-1
Observation.referenceRange.high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
Constraints: sqty-1
Observation.referenceRange.type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
Observation.referenceRange.appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
Observation.referenceRange.age 0..1 Range Applicable age range, if relevant
Observation.referenceRange.text 0..1 string Text based reference range in an observation
Observation.hasMember This element is included in summaries. 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
Observation.derivedFrom This element is included in summaries. 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
Observation.component This element is included in summaries. 0..* BackboneElement Component results
Observation.component.id 0..1 string Unique id for inter-element referencing
Observation.component.extension 0..* Extension Additional content defined by implementations
Observation.component.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
Observation.component.code This element is included in summaries. 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
Observation.component.value[x] This element is included in summaries. 0..1 Actual component result
Observation.component.value[x].valueQuantity Quantity
Observation.component.value[x].valueCodeableConcept CodeableConcept
Observation.component.value[x].valueString string
Observation.component.value[x].valueBoolean boolean
Observation.component.value[x].valueInteger integer
Observation.component.value[x].valueRange Range
Observation.component.value[x].valueRatio Ratio
Observation.component.value[x].valueSampledData SampledData
Observation.component.value[x].valueTime time
Observation.component.value[x].valueDateTime dateTime
Observation.component.value[x].valuePeriod Period
Observation.component.dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
Observation.component.interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
Observation.component.referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.value[x] Base preferred Fetal Presentations 📦2.0.0 This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression

 

Other representations of profile: CSV, Excel, Schematron