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 https://github.com/HL7/fhir-bfdr/ and changes regularly. See the Directory of published versions
Natality: When the child’s name is not chosen, a dataAbsentReason should be provided with code “temp-unknown.”
Fetal Death: When the decedent fetus is not named, a dataAbsentReason should be provided with code “unknown.”
If mother transferred for delivery, hospitalization.admitSource in the EncounterMaternity profile should be provided with code “hosp-trans” (from HL7 admit-source codesystem). Any other admitSource code will be interpreted as ‘N’, with “other” being the recommended code to express mother did not transfer. The absence of a code will be interpreted as Blank (NCHS may interpret as Unknown). If source of transfer is unknown, hospitalization.admitSource should be set to “hosp-trans” and hospitalization.origin.name should be set to “UNKNOWN” in the EncounterMaternity profile.
Similarly, if the infant transferred within 24 hours of delivery, hospitalization.dischargeDisposition in the EncounterBirth profile should be provided with code “other-hcf” (from HL7 discharge-disposition codesystem) Any other dischargeDisposition code will be interpreted as ‘N’, with “oth” being the recommended code to express infant did not transfer. The absence of a code will be interpreted as Blank (NCHS may interpret as Unknown). If destination of transfer is unknown, hospitalization.destination.name should be set to “UNKNOWN” in the EncounterBirth profile.
See the discussion of categories.
If ObservationNoneOfSpecifiedAbnormalConditionsOfNewborn is present in bundle, then the interpretation is that all individual Abnormal Conditions of the Newborn are ‘N’
If ObservationNoneOfSpecifiedMaternalMorbidities is present in bundle, then the interpretation is that all individual Maternal Morbities are ‘N’
If ObservationNoneOfSpecifiedCharacteristicsOfLaborAndDelivery is present in bundle, then the interpretation is that all individual Characteristics of Labor and Delivery are ‘N’
If ObservationNoneOfSpecifiedPregnancyRiskFactors is present in bundle, then the interpretation is that all individual Pregnancy Risk Factors are ‘N’
If ObservationNoneOfSpecifiedCongenitalAnomoliesOfTheNewborn is present in bundle, then the interpretation is that all individual Congenital Anomolies of the Newborn are ‘N’ and ConditionCongenitalAnomalyOfNewborn should not be used.
If ObservationNoneOfSpecifiedInfectionsPresentDuringPregnancy is present in bundle, then the interpretation is that all Infections During Pregnancy are ‘N’ and ConditionInfectionPresentDuringPregnancy should not be used.
If ObservationUnknownFinalRouteMethodDelivery is present in bundle, then the interpretation is that the method of delivery is unknown, and ProcedureFinalRouteMethodDelivery should not be used.
If ObservationNoneOfSpecifiedObstetricProcedures is present in bundle, then the interpretation is that external cephalic procedure was not performed, and ProcedureObstetric should not be used.
Since other infections and congenital anomalies could be of interest/value for use cases outside of natality, the value ‘Other’ is included in these valuesets (see InfectionsDuringPregnancyLiveBirthVS and NewbornCongenitalAnomaliesVS). However, use of #OTH is not allowed for submissions to NCHS.
TBD