Vital Records Birth and Fetal Death Reporting
1.1.0 - STU 1.1 United States of America flag

This page is part of the Vital Records Birth and Fetal Death Reporting (v1.1.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Example Bundle: Bundle - Provider Fetal Death Report - Fetus Not Named

Generated Narrative: Composition

Resource Composition "composition-provider-fetal-death-not-named"

Profile: Composition - Provider Fetal Death Report

Extension - Fetal Death Report Number: Fetal Death Report ID: 9876

Extension - Fetal Death Local File Number: Fetal Death Report File Number: 11111-11111

Extension - Date Received by Registrar: 2019-02-12

identifier: id: z03eab8c-11e8-4d0c-ad2a-b385395e27da

status: FINAL

type: U.S. standard report of fetal death - 2003 revision (LOINC#69045-3)

encounter: See above (Encounter/encounter-maternity-carmen-teresa-lee: Encounter - Maternity (Carmen Teresa Lee))

date: 2019-01-09

author: See above (Practitioner/practitioner-vital-records-jessica-leung: Practitioner - Vital Records (Jessica Leung))

title: Provider fetal death report Document

Mother (prenatal) Section on the Fetal Death Report

Medical and Health Information on the Fetal Death Report

Fetal delivery information section on the Fetal Death Report

Mother Administrative Section on the Fetal Death Report

Mother's QuestionnaireResponse Section

Additional Document Content

2. http://example.org/fhir/Patient/patient-decedent-fetus-not-named (Patient/patient-decedent-fetus-not-named)

UNK Female, DoB: 2019-01-09 ( Medical Record Number: 9932702 (use: USUAL))

3. http://example.org/fhir/Encounter/encounter-maternity-carmen-teresa-lee (Encounter/encounter-maternity-carmen-teresa-lee)

Not done yet

4. http://example.org/fhir/Practitioner/practitioner-vital-records-jessica-leung (Practitioner/practitioner-vital-records-jessica-leung)

Generated Narrative: Practitioner

Resource Practitioner "practitioner-vital-records-jessica-leung"

Profile: Practitioner - Vital Records

identifier: id: 223347055

name: Leung Jessica

Qualifications

-Code
*Birth Clerk (NullFlavor#OTH "other")

5. http://example.org/fhir/Patient/patient-mother-carmen-teresa-lee (Patient/patient-mother-carmen-teresa-lee)

Carmen Teresa Lee (OFFICIAL) Female, DoB: 1986-02-15 ( Medical Record Number: 9992702 (use: USUAL))

6. http://example.org/fhir/Observation/observation-planned-to-deliver-at-home-not-named (Observation/observation-planned-to-deliver-at-home-not-named)

Generated Narrative: Observation

Resource Observation "observation-planned-to-deliver-at-home-not-named"

Profile: Observation - Planned to Deliver at Home

status: FINAL

code: Planned to deliver at home? (LOINC#73765-0 "Mother Planned to deliver at home [US Standard Certificate of Live Birth]")

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

focus: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: false

7. http://example.org/fhir/Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee (Observation/observation-date-of-first-prenatal-care-visit-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-date-of-first-prenatal-care-visit-carmen-teresa-lee"

Profile: Observation - Date of First Prenatal Care Visit

status: FINAL

code: Date of first prenatal care visit (LOINC#69044-6 "Date first prenatal visit")

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

focus: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 2018-05-18

8. http://example.org/fhir/Observation/observation-last-menstrual-period-carmen-teresa-lee (Observation/observation-last-menstrual-period-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-last-menstrual-period-carmen-teresa-lee"

Profile: Observation - Last Menstrual Period - Vital Records

status: FINAL

code: Last menstrual period start date (LOINC#8665-2)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 2018-04-18

9. http://example.org/fhir/Observation/observation-number-births-now-living-carmen-teresa-lee (Observation/observation-number-births-now-living-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-births-now-living-carmen-teresa-lee"

Profile: Observation - Number of Births Now Living - Vital Records

status: FINAL

code: [#] Births.still living (LOINC#11638-4)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1

10. http://example.org/fhir/Observation/observation-number-births-now-dead-carmen-teresa-lee (Observation/observation-number-births-now-dead-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-births-now-dead-carmen-teresa-lee"

Profile: Observation - Number of Births Now Dead - Vital Records

status: FINAL

code: Previous live births now dead # (LOINC#68496-9)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 0

11. http://example.org/fhir/Observation/observation-date-of-last-live-birth-carmen-teresa-lee (Observation/observation-date-of-last-live-birth-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-date-of-last-live-birth-carmen-teresa-lee"

Profile: Observation - Date of Last Live Birth

status: FINAL

code: Date of last live birth (LOINC#68499-3 "Date last live birth")

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

focus: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 2016-01-28

12. http://example.org/fhir/Observation/observation-mother-height-carmen-teresa-lee (Observation/observation-mother-height-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-mother-height-carmen-teresa-lee"

Profile: Observation - Mother Height - Vital Records

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Body height Measured (LOINC#3137-7)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-01-10

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 65 [in_i] (Details: UCUM code [in_i] = '[in_i]')

13. http://example.org/fhir/Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee (Observation/observation-mother-prepregnancy-weight-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-mother-prepregnancy-weight-carmen-teresa-lee"

Profile: Observation - Mother Prepregnancy Weight - Vital Records

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Body weight --pre current pregnancy (LOINC#56077-1)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-05-20

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 180 [lb_av] (Details: UCUM code [lb_av] = '[lb_av]')

14. http://example.org/fhir/Observation/observation-mother-received-wic-food-carmen-teresa-lee (Observation/observation-mother-received-wic-food-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-mother-received-wic-food-carmen-teresa-lee"

Profile: Observation - Mother Recieved WIC Food

status: FINAL

code: Did mother get WIC food for herself during this pregnancy? (LOINC#87303-4 "Mother WIC food recipient")

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

focus: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: No (expandedYes-NoIndicator#N)

15. http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-1-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-1-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: In the 3 months before you got pregnant, how many cigarettes did you smoke on an average day [PhenX] (LOINC#64794-1)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 0

16. http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-2-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-2-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: Cigarettes smoked per day by Mother--1st trimester (LOINC#87298-6)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 0

17. http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-3-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-3-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: Cigarettes smoked per day by Mother--2nd trimester (LOINC#87299-4)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 1

18. http://example.org/fhir/Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee (Observation/observation-cig-smoking-pregnancy-4-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-cig-smoking-pregnancy-4-carmen-teresa-lee"

Profile: Observation - Cigarette Smoking Before and During Pregnancy

status: FINAL

code: In the last 3 months of your pregnancy, how many cigarettes did you smoke on an average day [PhenX] (LOINC#64795-8)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

focus: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 0

19. http://example.org/fhir/Observation/observation-number-previous-cesareans-carmen-teresa-lee (Observation/observation-number-previous-cesareans-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-number-previous-cesareans-carmen-teresa-lee"

Profile: Observation - Number of Previous Cesareans - Vital Records

status: FINAL

code: Previous cesarean deliveries # (LOINC#68497-7)

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1

20. http://example.org/fhir/Observation/observation-fetal-presentation-not-named (Observation/observation-fetal-presentation-not-named)

Generated Narrative: Observation

Resource Observation "observation-fetal-presentation-not-named"

Profile: Observation - Fetal Presentation at Birth/Delivery

status: FINAL

code: Fetal presentation--at birth [US Standard Certificate of Live Birth] (LOINC#73761-9)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Breech presentation (finding) (SNOMED CT#6096002)

21. http://example.org/fhir/Procedure/procedure-final-route-method-delivery-not-named (Procedure/procedure-final-route-method-delivery-not-named)

Generated Narrative: Procedure

Resource Procedure "procedure-final-route-method-delivery-not-named"

Profile: Procedure - Final Route and Method of Delivery

status: COMPLETED

code: Spontaneous vaginal delivery (SNOMED CT#48782003 "Delivery normal (finding)")

subject: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

22. http://example.org/fhir/Observation/observation-birth-weight-not-named (Observation/observation-birth-weight-not-named)

Generated Narrative: Observation

Resource Observation "observation-birth-weight-not-named"

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Birth weight Measured (LOINC#8339-4)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-02-10

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 1530 g (Details: UCUM code g = 'g')

23. http://example.org/fhir/Observation/observation-gestational-age-at-delivery-not-named (Observation/observation-gestational-age-at-delivery-not-named)

Generated Narrative: Observation

Resource Observation "observation-gestational-age-at-delivery-not-named"

Profile: Observation - Gestational Age at Delivery - Vital Records

status: FINAL

code: Gestational age Estimated (LOINC#11884-4)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: 20 wk (Details: UCUM code wk = 'wk')

24. http://example.org/fhir/Condition/condition-fetal-death-cause-or-condition-not-named (Condition/condition-fetal-death-cause-or-condition-not-named)

Generated Narrative: Condition

Resource Condition "condition-fetal-death-cause-or-condition-not-named"

Profile: Condition - Fetal Death Cause or Condition

category: Encounter Diagnosis (Condition Category Codes#encounter-diagnosis), Initiating cause or condition of fetal death [US Standard Report of Fetal Death] (LOINC#76060-3)

code: Premature rupture of membranes (disorder) (SNOMED CT#44223004)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

25. http://example.org/fhir/Condition/condition-fetal-death-other-significant-cause-not-named (Condition/condition-fetal-death-other-significant-cause-not-named)

Generated Narrative: Condition

Resource Condition "condition-fetal-death-other-significant-cause-not-named"

Profile: Condition - Fetal Death Other Cause or Condition

category: Encounter Diagnosis (Condition Category Codes#encounter-diagnosis), Other significant causes or conditions of fetal death [US Standard Report of Fetal Death] (LOINC#76061-1)

code: Placental insufficiency (disorder) (SNOMED CT#237292005)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

26. http://example.org/fhir/Observation/observation-fetal-death-time-point-not-named (Observation/observation-fetal-death-time-point-not-named)

Generated Narrative: Observation

Resource Observation "observation-fetal-death-time-point-not-named"

Profile: Observation - Fetal Death Time Point

status: FINAL

code: Estimated timing of fetal death [US Standard Report of Fetal Death] (LOINC#73811-2)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Fetal intrapartum death after first assessment (event) (SNOMED CT#434631000124100)

27. http://example.org/fhir/Observation/observation-autopsy-performed-not-named (Observation/observation-autopsy-performed-not-named)

Generated Narrative: Observation

Resource Observation "observation-autopsy-performed-not-named"

Profile: Observation - Autopsy Performed Indicator - Vital Records

status: FINAL

code: Autopsy was performed (LOINC#85699-7)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Autopsy performed (situation) (SNOMED CT#716347009)

28. http://example.org/fhir/Observation/observation-histological-placental-exam-performed-not-named (Observation/observation-histological-placental-exam-performed-not-named)

Generated Narrative: Observation

Resource Observation "observation-histological-placental-exam-performed-not-named"

Profile: Observation - Histological Placental Exam Performed

status: FINAL

code: Histological placental examination was performed [US Standard Report of Fetal Death] (LOINC#73767-6)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Performed (SNOMED CT#398166005)

29. http://example.org/fhir/Observation/observation-autopsy-histological-exam-results-used-not-named (Observation/observation-autopsy-histological-exam-results-used-not-named)

Generated Narrative: Observation

Resource Observation "observation-autopsy-histological-exam-results-used-not-named"

Profile: Observation - Autopsy or Histological Exam Results Used

status: FINAL

code: Autopsy or histological placental examination results were used [US Standard Report of Fetal Death] (LOINC#74498-7)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

effective: 2019-12-02

performer: See above (Practitioner/practitioner-vital-records-janet-seito)

value: Yes (v2 Y/N Indicator#Y)

30. http://example.org/fhir/Observation/observation-parent-education-level-carmen-teresa-lee (Observation/observation-parent-education-level-carmen-teresa-lee)

Generated Narrative: Observation

Resource Observation "observation-parent-education-level-carmen-teresa-lee"

Profile: Observation - Parent Education Level - Vital Records

status: FINAL

code: Highest level of education Mother (LOINC#57712-2)

subject: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

focus: See above (Patient/patient-mother-carmen-teresa-lee: Patient - Mother (Carmen Teresa Lee))

effective: 2019-12-02

performer: See above (Patient/patient-mother-carmen-teresa-lee)

value: 9th through 12th grade; no diploma (unknown#PHC1449)

31. http://example.org/fhir/QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee (QuestionnaireResponse/QuestionnaireResponse-patients-fetal-death-carmen-lee)

LinkIdTextDefinitionAnswerdoco
.. QuestionnaireResponse-patients-fetal-death-carmen-leeQuestionnaireResponse
... mother-current-legal-nameWhat is your current legal name?
... mother-addressWhere do you usually live - that is - where is your household/residence located?
... inside-city-limitsIs this household inside city limits (inside the incorporated limits of the city, town, or location where you live)?
... mother-dobWhat is your date of birth?
... mother-birthplaceIn what State, U.S. territory, or foreign country were you born? Please specify one of the following:
... mother-educationWhat is the highest level of schooling that you have completed at the time of delivery? (Check the box that best describes your education. If you are currently enrolled, check the box that indicates the previous grade or highest degree received).
... mother-ethnicityAre you Spanish/Hispanic/Latina? If not Spanish/Hispanic/Latina, check the “No” box. If Spanish/Hispanic/Latina, check the appropriate box.
... mother-raceWhat is your race? (Please check one or more races to indicate what you consider yourself to be).
... father-current-legal-nameWhat is the current legal name of your baby's father?
... father-dobWhat is the father's date of birth?
... father-birthplaceIn what State, U.S. territory, or foreign country was the father born? Please specify one of the following:
... receive-wicDid you receive WIC (Women, Infants and Children) food for yourself during this pregnancy?
... mothers-heightWhat is your height?
... mothers-prepregnancy-weightlbs
... mothers-smokingHow many cigarettes OR packs of cigarettes did you smoke on an average day during each of the following time periods? If you NEVER smoked, enter zero for each time period.

doco Documentation for this format

32. http://example.org/fhir/Practitioner/practitioner-vital-records-janet-seito (Practitioner/practitioner-vital-records-janet-seito)

Generated Narrative: Practitioner

Resource Practitioner "practitioner-vital-records-janet-seito"

Profile: Practitioner - Vital Records

identifier: id: 223347044

name: Avery Jones

Qualifications

-Code
*Osteopath (occupation) (SNOMED CT#76231001)

33. http://example.org/fhir/Location/location-south-hospital (Location/location-south-hospital)

Generated Narrative: Location

Resource Location "location-south-hospital"

Profile: US Core Location Profile

status: ACTIVE

name: South Hospital

type: Hospital (RoleCode#HOSP)

34. http://example.org/fhir/Organization/organization-south-hospital (Organization/organization-south-hospital)

Generated Narrative: Organization

Resource Organization "organization-south-hospital"

identifier: id: 5555512

active: true

type: Hospital (RoleCode#HOSP)

name: South Hospital

Contacts

-TelecomAddress
*+1-555-555-1111, mail@southhospital.com2100 North Ave Salt Lake City UT 84116 US

35. http://example.org/fhir/RelatedPerson/relatedperson-mother-carmen-teresa-lee (RelatedPerson/relatedperson-mother-carmen-teresa-lee)

Generated Narrative: RelatedPerson

Resource RelatedPerson "relatedperson-mother-carmen-teresa-lee"

Profile: RelatedPerson - Mother Gestational - Vital Records

US Core Race Extension

url

ombCategory

value: Black or African American (Details: urn:oid:2.16.840.1.113883.6.238 code 2054-5 = 'Black or African American', stated as 'Black or African American')

url

text

value: Black or African America

US Core Ethnicity Extension

url

ombCategory

value: Hispanic or Latino (Details: urn:oid:2.16.840.1.113883.6.238 code 2135-2 = 'Hispanic or Latino', stated as 'Hispanic or Latino')

url

text

value: Hispanic or Latino

active: true

patient: See above (Patient/patient-decedent-fetus-not-named: Patient - Decedent Fetus (Fetus Not Named))

relationship: Gestational Mother (RoleCode#GESTM "gestational mother")

name: Carmen Teresa Lee (OFFICIAL)

gender: FEMALE

birthDate: 1986-02-15