Birth And Fetal Death (BFDR) - STU2-ballot
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Birth And Fetal Death (BFDR) - STU2-ballot, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.0.0-Preview1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of and changes regularly. See the Directory of published versions

Fetal Death Report Example - Not Named

This example provides a narrative description of the fetal report for Fetus Not Named, following the fetal death report. This information is transmitted in both a Provider bundle to the VRO, and in a Jurisdiction bundle to NCHS. The main difference between the two bundles is the inclusion of edit flags.

Field(s) Example Instance
Decedent Fetus Fetus Not Named
Mother Carmen Teresa Lee
Father Tom Yan Lee. Only included in questionnaire
Attendant Janet Seito
Maternity Encounter Maternity Encounter
Author Jessica Leung
Intiating Cause of Fetal Death Premature Rupture of Membrances
Other Causes of Fetal Death Placental insufficiency
Newborn Birthweight 1530g
Obstetric Estimate of Gestation 20 wk
Fetal Death Time Point Fetal intrapartum death after first assessment
Autopsy Performed Yes
Placental Exam Performed
Histological Exam Results Used Yes
Mother’s Education Some secondary or high school education
Mother’s Usual Work-Occupation Secretary
Mother’s Usual Work-Industry State Agency
Mother’s Race and Ethnicity White/Black/AIAN/Hispanic
Father’s Usual Work-Occupation Teaching Assistant
Father’s Usual Work-Industry Elementary and Secondary Schools
First Prenatal Care Visit Date 2018-05-18
Mother’s Height 65 in
Mother’s Prepregnancy Weight 180 lb
Mother WIC Food No
Number of Previous Live Births Living = 1, Dead = 0
Last Live Birth Date 2016-01-28
Cigarette Smoking First Trimester = 0, Second Trimester = 0, Third Trimester = 1, Fourth Trimester = 0
Last Normal Menses Date 2018-04-18
Number of Deaths this Delivery 1
Mother Transferred No
Risk Factors During Pregnancy Gestational Diabetes
Number of Previous Cesareans Cesareans = 1
Fetal Presentation Breech
Final Route/Method of Delivery Vaginal