For the most part, labor and delivery takes place at a healthcare provider site. When the delivery takes place at home, or on the way to the hospital, the mother and fetus will be taken to the hospital for evaluation and possible treatment. Personal and pregnancy information is collected from the mother or an informant, while information regarding labor and delivery and the fetus is collected from the responsible party at the healthcare facility.

The data requirements for provider supplied fetal death information are based on the

• 2003 Revision of the U.S. Standard Report of Fetal Death
• 2019 US Standard Facility Worksheet for the Report of Fetal Death
• 2019 US Standard Patient’s Worksheet for the Report of Fetal Death

The jurisdiction may have additional data requirements and edit specifications that will be addressed at the jurisdictional level.

The 1992 Revision of the Model State Vital Statistics Act and Regulations recommends the following definition of fetal death:

“Fetal death” means death prior to the complete expulsion or extraction from its mother of a product of human conception, irrespective of the duration of pregnancy and which is not an induced termination of pregnancy. The death is indicated by the fact that after such expulsion or extraction, the fetus does not breathe or show any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. Heartbeats are to be distinguished from transient cardiac contractions; respirations are to be distinguished from fleeting respiratory efforts or gasps.

See Patient Worksheet Questionnaires for information about including a QuestionnaireResponse in this Composition.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
fetalDeathReportNumber	S	0..1	Identifier	State File Number URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-number
fetalDeathLocalFileNumber	S	0..1	Identifier	Local File No. URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-local-file-number
dateReceivedByRegistrar	S	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-date-received-by-registrar
replacementStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-replacement-status Binding: ValueSet - Replacement Status (required)
status	S	1..1	code	In the case of a fetal death sent in error, a status of 'entered-in-error' must be set.
type	S	1..1	CodeableConcept	U.S. standard report of fetal death - 2003 revision Required Pattern: At least the following
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: 69045-3
subject	S	1..1	Reference(Patient - Decedent Fetus - Vital Records)	The subject of the composition is the decedent fetus: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the name of the decedent fetus.
encounter	S	0..1	Reference(Encounter - Maternity)	The Encounter for the Composition is the mother's maternity encounter.
Extension-encounter-maternity-reference		0..*	Reference(Encounter - Maternity)	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-encounter-maternity-reference
date	S	1..1	dateTime	Date report completed
author	S	1..1	Reference(Practitioner - Vital Records)	The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
Slices for section	S	1..*	BackboneElement	The Composition is broken into sections that, where possible, align with the sections in the Fetal Death Report. Slice: Unordered, Open by pattern:code
section:motherPrenatal	S	0..1	BackboneElement	Mother (prenatal) section on the Fetal Death Report
code	S	1..1	CodeableConcept	Prenatal records Required Pattern: At least the following
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: 57073-9
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the mother's name, address, dob, birthplace, race, and ethnicity.
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the Mother Prenatal section Slice: Unordered, Open by profile:$this.resolve()
entry:plannedToDeliverAtHome	S	0..1	Reference(Observation - Planned to Deliver at Home)	Planned to deliver at home
entry:firstPrenatalCareVisit	S	0..1	Reference(Observation - Date of First Prenatal Care Visit)	First prenatal care visit
entry:dateLastNormalMenses	S	0..1	Reference(Observation - Last Menstrual Period - Vital Records)	Date last normal menses began
entry:numberNowLiving	S	0..1	Reference(Observation - Number of Births Now Living - Vital Records)	Number of previous live births now living
entry:numberNowDead	S	0..1	Reference(Observation - Number of Births Now Dead - Vital Records)	Number of previous live births now dead
entry:dateLastLiveBirth	S	0..1	Reference(Observation - Date of Last Live Birth)	Date of last live birth
entry:mothersHeight	S	0..1	Reference(Observation - Mother Height - Vital Records)	Mother's height: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:mothersPrepregnancyWeight	S	0..1	Reference(Observation - Mother Prepregnancy Weight - Vital Records)	Mother's prepregnancy weight: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:motherReceivedWICFood	S	0..1	Reference(Observation - Mother Recieved WIC Food)	Use of the WIC nutritional program by the mother: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:cigaretteSmokingBeforeDuringPregnancy	S	0..4	Reference(Observation - Cigarette Smoking Before and During Pregnancy)	Cigarettes smoked by the mother before and during the pregnancy: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
section:medicalHealthInformation	S	0..1	BackboneElement	Medical and Health Information section on the Fetal Death Report
code	S	1..1	CodeableConcept	Clinical information Required Pattern: At least the following
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: 55752-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the medical and health information section Slice: Unordered, Open by profile:$this.resolve()
entry:pregnancyRiskFactors	S	0..*	Reference(Condition - Prepregnancy Diabetes - Vital Records | Condition - Gestational Diabetes - Vital Records | Condition - Prepregnancy Hypertension - Vital Records | Condition - Gestational Hypertension - Vital Records | Condition - Eclampsia Hypertension - Vital Records | Observation - Previous Preterm Birth - Vital Records | Procedure - Infertility Treatment - Vital Records | Procedure - Artificial Insemination - Vital Records | Procedure - Assisted Fertilization - Vital Records | Observation - Previous Cesarean - Vital Records | Observation - None Of Specified Pregnancy Risk Factors - Vital Records)	Risk factors in this pregnancy
entry:numberPreviousCesareans	S	0..1	Reference(Observation - Number of Previous Cesareans - Vital Records)	If mother had a previous cesarean delivery, how many
entry:fetalPresentation	S	0..1	Reference(Observation - Fetal Presentation at Birth/Delivery)	Fetal presentation at birth
entry:finalRouteMethodDelivery	S	0..1	Reference(Procedure - Final Route and Method of Delivery)	Final route and method of delivery
entry:maternalMorbidity	S	0..*	Reference(Procedure - Blood Transfusion | Condition - Perineal Laceration | Condition - Ruptured Uterus | Procedure - Unplanned Hysterectomy | Observation - ICU Admission | Observation - None Of Specified Maternal Morbidities)	Maternal morbidity (complications associated with labor and delivery)
section:fetus	S	0..1	BackboneElement	fetus section on the Fetal Death Report
code	S	1..1	CodeableConcept	Fetal delivery information Document [US Standard Report of Fetal Death] Required Pattern: At least the following
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: 76400-1
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the fetus section Slice: Unordered, Open by profile:$this.resolve()
entry:deliveryWeight	S	0..1	Reference(Observation - Birth Weight - Vital Records)	Delivery weight
entry:gestationalAgeAtDelivery	S	0..1	Reference(Observation - Gestational Age at Delivery - Vital Records)	Obstetric estimate of gestation
entry:causeOfFetalDeath	S	0..1	Reference(Condition - Fetal Death Cause or Condition)	Initiating cause or condition of fetal death
entry:otherCauseOfDeath	S	0..*	Reference(Condition - Fetal Death Other Cause or Condition)	Another significant cause or condition for the death of the fetus.
entry:estimatedTimeFetalDeath	S	1..1	Reference(Observation - Fetal Death Time Point)	The estimated time of fetal death; the time of death is characterized by the relationship to the time of delivery.
entry:autopsyPerformed	S	0..1	Reference(Observation - Autopsy Performed Indicator - Vital Records)	An indication if an autopsy has been performed on the subject.
entry:histologicalExamPerformed	S	0..1	Reference(Observation - Histological Placental Exam Performed)	Whether or not a histological placental examination was performed.
entry:autopsyOrHistologicalExamUsed	S	0..1	Reference(Observation - Autopsy or Histological Exam Results Used)	Whether or not the results of a performed autopsy or a performed histological placental examination were used as part of determining the cause of death.
entry:numberLiveBirthsThisDelivery	S	0..1	Reference(Observation - Number of Live Births This Delivery - Vital Records)	Number of live births this delivery
entry:numberFetalDeathsThisDelivery	S	0..1	Reference(Observation - Number of Fetal Deaths This Delivery - Vital Records)	Number of fetal deaths this delivery
section:motherInformation	S	0..1	BackboneElement	Mother administrative section on the Fetal Death Report
code	S	1..1	CodeableConcept	Mother's administrative information Required Pattern: At least the following
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: 92014-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
Slices for entry	S	1..*	Reference(Resource)	Entries that are contained in the motherInformation section Slice: Unordered, Open by profile:$this.resolve()
entry:mothersEducation	S	0..1	Reference(Observation - Parent Education Level - Vital Records)	Mother's education: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
section:fatherInformation	S	0..1	BackboneElement	Father section on the Fetal Death Report
code	S	1..1	CodeableConcept	Father's administrative information Required Pattern: At least the following
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: 92013-2
focus	S	1..1	Reference(RelatedPerson - Father Natural - Vital Records)	The focus of this section is the father: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the father's name, dob, and birthplace.
section:patientsQuestionnaireResponse		0..1	BackboneElement	Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
code		1..1	CodeableConcept	Questionnaire response Document Required Pattern: At least the following
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: 74465-6
entry		1..1	Reference(QuestionnaireResponse)	QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
fetalDeathReportNumber	S	0..1	Identifier	State File Number URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-number
fetalDeathLocalFileNumber	S	0..1	Identifier	Local File No. URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-local-file-number
dateReceivedByRegistrar	S	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-date-received-by-registrar
replacementStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-replacement-status Binding: ValueSet - Replacement Status (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	In the case of a fetal death sent in error, a status of 'entered-in-error' must be set. Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	SΣ	1..1	CodeableConcept	U.S. standard report of fetal death - 2003 revision Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
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: 69045-3
subject	SΣ	1..1	Reference(Patient - Decedent Fetus - Vital Records)	The subject of the composition is the decedent fetus: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the name of the decedent fetus.
encounter	SΣ	0..1	Reference(Encounter - Maternity)	The Encounter for the Composition is the mother's maternity encounter.
Extension-encounter-maternity-reference		0..*	Reference(Encounter - Maternity)	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-encounter-maternity-reference Slice: Unordered, Open by value:url
date	SΣ	1..1	dateTime	Date report completed
author	SΣ	1..1	Reference(Practitioner - Vital Records)	The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
title	Σ	1..1	string	Human Readable name/title
Slices for section	SC	1..*	BackboneElement	The Composition is broken into sections that, where possible, align with the sections in the Fetal Death Report. Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
section:motherPrenatal	SC	0..1	BackboneElement	Mother (prenatal) section on the Fetal Death Report
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Prenatal records Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
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: 57073-9
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the mother's name, address, dob, birthplace, race, and ethnicity.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the Mother Prenatal section Slice: Unordered, Open by profile:$this.resolve()
entry:plannedToDeliverAtHome	SC	0..1	Reference(Observation - Planned to Deliver at Home)	Planned to deliver at home
entry:firstPrenatalCareVisit	SC	0..1	Reference(Observation - Date of First Prenatal Care Visit)	First prenatal care visit
entry:dateLastNormalMenses	SC	0..1	Reference(Observation - Last Menstrual Period - Vital Records)	Date last normal menses began
entry:numberNowLiving	SC	0..1	Reference(Observation - Number of Births Now Living - Vital Records)	Number of previous live births now living
entry:numberNowDead	SC	0..1	Reference(Observation - Number of Births Now Dead - Vital Records)	Number of previous live births now dead
entry:dateLastLiveBirth	SC	0..1	Reference(Observation - Date of Last Live Birth)	Date of last live birth
entry:mothersHeight	SC	0..1	Reference(Observation - Mother Height - Vital Records)	Mother's height: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:mothersPrepregnancyWeight	SC	0..1	Reference(Observation - Mother Prepregnancy Weight - Vital Records)	Mother's prepregnancy weight: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:motherReceivedWICFood	SC	0..1	Reference(Observation - Mother Recieved WIC Food)	Use of the WIC nutritional program by the mother: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:cigaretteSmokingBeforeDuringPregnancy	SC	0..4	Reference(Observation - Cigarette Smoking Before and During Pregnancy)	Cigarettes smoked by the mother before and during the pregnancy: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
section:medicalHealthInformation	SC	0..1	BackboneElement	Medical and Health Information section on the Fetal Death Report
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Clinical information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
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: 55752-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the medical and health information section Slice: Unordered, Open by profile:$this.resolve()
entry:pregnancyRiskFactors	SC	0..*	Reference(Condition - Prepregnancy Diabetes - Vital Records | Condition - Gestational Diabetes - Vital Records | Condition - Prepregnancy Hypertension - Vital Records | Condition - Gestational Hypertension - Vital Records | Condition - Eclampsia Hypertension - Vital Records | Observation - Previous Preterm Birth - Vital Records | Procedure - Infertility Treatment - Vital Records | Procedure - Artificial Insemination - Vital Records | Procedure - Assisted Fertilization - Vital Records | Observation - Previous Cesarean - Vital Records | Observation - None Of Specified Pregnancy Risk Factors - Vital Records)	Risk factors in this pregnancy
entry:numberPreviousCesareans	SC	0..1	Reference(Observation - Number of Previous Cesareans - Vital Records)	If mother had a previous cesarean delivery, how many
entry:fetalPresentation	SC	0..1	Reference(Observation - Fetal Presentation at Birth/Delivery)	Fetal presentation at birth
entry:finalRouteMethodDelivery	SC	0..1	Reference(Procedure - Final Route and Method of Delivery)	Final route and method of delivery
entry:maternalMorbidity	SC	0..*	Reference(Procedure - Blood Transfusion | Condition - Perineal Laceration | Condition - Ruptured Uterus | Procedure - Unplanned Hysterectomy | Observation - ICU Admission | Observation - None Of Specified Maternal Morbidities)	Maternal morbidity (complications associated with labor and delivery)
section:fetus	SC	0..1	BackboneElement	fetus section on the Fetal Death Report
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Fetal delivery information Document [US Standard Report of Fetal Death] Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
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: 76400-1
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the fetus section Slice: Unordered, Open by profile:$this.resolve()
entry:deliveryWeight	SC	0..1	Reference(Observation - Birth Weight - Vital Records)	Delivery weight
entry:gestationalAgeAtDelivery	SC	0..1	Reference(Observation - Gestational Age at Delivery - Vital Records)	Obstetric estimate of gestation
entry:causeOfFetalDeath	SC	0..1	Reference(Condition - Fetal Death Cause or Condition)	Initiating cause or condition of fetal death
entry:otherCauseOfDeath	SC	0..*	Reference(Condition - Fetal Death Other Cause or Condition)	Another significant cause or condition for the death of the fetus.
entry:estimatedTimeFetalDeath	SC	1..1	Reference(Observation - Fetal Death Time Point)	The estimated time of fetal death; the time of death is characterized by the relationship to the time of delivery.
entry:autopsyPerformed	SC	0..1	Reference(Observation - Autopsy Performed Indicator - Vital Records)	An indication if an autopsy has been performed on the subject.
entry:histologicalExamPerformed	SC	0..1	Reference(Observation - Histological Placental Exam Performed)	Whether or not a histological placental examination was performed.
entry:autopsyOrHistologicalExamUsed	SC	0..1	Reference(Observation - Autopsy or Histological Exam Results Used)	Whether or not the results of a performed autopsy or a performed histological placental examination were used as part of determining the cause of death.
entry:numberLiveBirthsThisDelivery	SC	0..1	Reference(Observation - Number of Live Births This Delivery - Vital Records)	Number of live births this delivery
entry:numberFetalDeathsThisDelivery	SC	0..1	Reference(Observation - Number of Fetal Deaths This Delivery - Vital Records)	Number of fetal deaths this delivery
section:motherInformation	SC	0..1	BackboneElement	Mother administrative section on the Fetal Death Report
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Mother's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
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: 92014-0
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the motherInformation section Slice: Unordered, Open by profile:$this.resolve()
entry:mothersEducation	SC	0..1	Reference(Observation - Parent Education Level - Vital Records)	Mother's education: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
section:fatherInformation	SC	0..1	BackboneElement	Father section on the Fetal Death Report
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	S	1..1	CodeableConcept	Father's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
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: 92013-2
focus	S	1..1	Reference(RelatedPerson - Father Natural - Vital Records)	The focus of this section is the father: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the father's name, dob, and birthplace.
section:patientsQuestionnaireResponse	C	0..1	BackboneElement	Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Questionnaire response Document Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
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: 74465-6
entry	C	1..1	Reference(QuestionnaireResponse)	QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.status	required	CompositionStatus
Composition.type	preferred	Pattern: LOINC code 69045-3
Composition.section:motherPrenatal.code	example	Pattern: LOINC code 57073-9
Composition.section:medicalHealthInformation.code	example	Pattern: LOINC code 55752-0
Composition.section:fetus.code	example	Pattern: LOINC code 76400-1
Composition.section:motherInformation.code	example	Pattern: LOINC code 92014-0
Composition.section:fatherInformation.code	example	Pattern: LOINC code 92013-2
Composition.section:patientsQuestionnaireResponse.code	example	Pattern: LOINC code 74465-6

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:fetus, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:fetus, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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 : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
fetalDeathReportNumber	S	0..1	Identifier	State File Number URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-number
fetalDeathLocalFileNumber	S	0..1	Identifier	Local File No. URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-local-file-number
dateReceivedByRegistrar	S	1..1	dateTime	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-date-received-by-registrar
replacementStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-replacement-status Binding: ValueSet - Replacement Status (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Version-independent identifier for the Composition
status	?!SΣ	1..1	code	In the case of a fetal death sent in error, a status of 'entered-in-error' must be set. Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	SΣ	1..1	CodeableConcept	U.S. standard report of fetal death - 2003 revision Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 69045-3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	SΣ	1..1	Reference(Patient - Decedent Fetus - Vital Records)	The subject of the composition is the decedent fetus: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the name of the decedent fetus.
encounter	SΣ	0..1	Reference(Encounter - Maternity)	The Encounter for the Composition is the mother's maternity encounter.
id		0..1	string	Unique id for inter-element referencing
Extension-encounter-maternity-reference		0..*	Reference(Encounter - Maternity)	Extension URL: http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-encounter-maternity-reference Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
date	SΣ	1..1	dateTime	Date report completed
author	SΣ	1..1	Reference(Practitioner - Vital Records)	The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	SC	1..*	BackboneElement	The Composition is broken into sections that, where possible, align with the sections in the Fetal Death Report. Slice: Unordered, Open by pattern:code
section:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:motherPrenatal	SC	0..1	BackboneElement	Mother (prenatal) section on the Fetal Death Report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Prenatal records Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 57073-9
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the mother's name, address, dob, birthplace, race, and ethnicity.
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the Mother Prenatal section Slice: Unordered, Open by profile:$this.resolve()
entry:plannedToDeliverAtHome	SC	0..1	Reference(Observation - Planned to Deliver at Home)	Planned to deliver at home
entry:firstPrenatalCareVisit	SC	0..1	Reference(Observation - Date of First Prenatal Care Visit)	First prenatal care visit
entry:dateLastNormalMenses	SC	0..1	Reference(Observation - Last Menstrual Period - Vital Records)	Date last normal menses began
entry:numberNowLiving	SC	0..1	Reference(Observation - Number of Births Now Living - Vital Records)	Number of previous live births now living
entry:numberNowDead	SC	0..1	Reference(Observation - Number of Births Now Dead - Vital Records)	Number of previous live births now dead
entry:dateLastLiveBirth	SC	0..1	Reference(Observation - Date of Last Live Birth)	Date of last live birth
entry:mothersHeight	SC	0..1	Reference(Observation - Mother Height - Vital Records)	Mother's height: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:mothersPrepregnancyWeight	SC	0..1	Reference(Observation - Mother Prepregnancy Weight - Vital Records)	Mother's prepregnancy weight: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:motherReceivedWICFood	SC	0..1	Reference(Observation - Mother Recieved WIC Food)	Use of the WIC nutritional program by the mother: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
entry:cigaretteSmokingBeforeDuringPregnancy	SC	0..4	Reference(Observation - Cigarette Smoking Before and During Pregnancy)	Cigarettes smoked by the mother before and during the pregnancy: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:medicalHealthInformation	SC	0..1	BackboneElement	Medical and Health Information section on the Fetal Death Report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Clinical information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55752-0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the medical and health information section Slice: Unordered, Open by profile:$this.resolve()
entry:pregnancyRiskFactors	SC	0..*	Reference(Condition - Prepregnancy Diabetes - Vital Records | Condition - Gestational Diabetes - Vital Records | Condition - Prepregnancy Hypertension - Vital Records | Condition - Gestational Hypertension - Vital Records | Condition - Eclampsia Hypertension - Vital Records | Observation - Previous Preterm Birth - Vital Records | Procedure - Infertility Treatment - Vital Records | Procedure - Artificial Insemination - Vital Records | Procedure - Assisted Fertilization - Vital Records | Observation - Previous Cesarean - Vital Records | Observation - None Of Specified Pregnancy Risk Factors - Vital Records)	Risk factors in this pregnancy
entry:numberPreviousCesareans	SC	0..1	Reference(Observation - Number of Previous Cesareans - Vital Records)	If mother had a previous cesarean delivery, how many
entry:fetalPresentation	SC	0..1	Reference(Observation - Fetal Presentation at Birth/Delivery)	Fetal presentation at birth
entry:finalRouteMethodDelivery	SC	0..1	Reference(Procedure - Final Route and Method of Delivery)	Final route and method of delivery
entry:maternalMorbidity	SC	0..*	Reference(Procedure - Blood Transfusion | Condition - Perineal Laceration | Condition - Ruptured Uterus | Procedure - Unplanned Hysterectomy | Observation - ICU Admission | Observation - None Of Specified Maternal Morbidities)	Maternal morbidity (complications associated with labor and delivery)
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:fetus	SC	0..1	BackboneElement	fetus section on the Fetal Death Report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Fetal delivery information Document [US Standard Report of Fetal Death] Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 76400-1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the fetus section Slice: Unordered, Open by profile:$this.resolve()
entry:deliveryWeight	SC	0..1	Reference(Observation - Birth Weight - Vital Records)	Delivery weight
entry:gestationalAgeAtDelivery	SC	0..1	Reference(Observation - Gestational Age at Delivery - Vital Records)	Obstetric estimate of gestation
entry:causeOfFetalDeath	SC	0..1	Reference(Condition - Fetal Death Cause or Condition)	Initiating cause or condition of fetal death
entry:otherCauseOfDeath	SC	0..*	Reference(Condition - Fetal Death Other Cause or Condition)	Another significant cause or condition for the death of the fetus.
entry:estimatedTimeFetalDeath	SC	1..1	Reference(Observation - Fetal Death Time Point)	The estimated time of fetal death; the time of death is characterized by the relationship to the time of delivery.
entry:autopsyPerformed	SC	0..1	Reference(Observation - Autopsy Performed Indicator - Vital Records)	An indication if an autopsy has been performed on the subject.
entry:histologicalExamPerformed	SC	0..1	Reference(Observation - Histological Placental Exam Performed)	Whether or not a histological placental examination was performed.
entry:autopsyOrHistologicalExamUsed	SC	0..1	Reference(Observation - Autopsy or Histological Exam Results Used)	Whether or not the results of a performed autopsy or a performed histological placental examination were used as part of determining the cause of death.
entry:numberLiveBirthsThisDelivery	SC	0..1	Reference(Observation - Number of Live Births This Delivery - Vital Records)	Number of live births this delivery
entry:numberFetalDeathsThisDelivery	SC	0..1	Reference(Observation - Number of Fetal Deaths This Delivery - Vital Records)	Number of fetal deaths this delivery
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:motherInformation	SC	0..1	BackboneElement	Mother administrative section on the Fetal Death Report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Mother's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92014-0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(Patient - Mother - Vital Records)	The focus of this section is the mother
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
Slices for entry	SC	1..*	Reference(Resource)	Entries that are contained in the motherInformation section Slice: Unordered, Open by profile:$this.resolve()
entry:mothersEducation	SC	0..1	Reference(Observation - Parent Education Level - Vital Records)	Mother's education: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for this data element.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:fatherInformation	SC	0..1	BackboneElement	Father section on the Fetal Death Report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code	S	1..1	CodeableConcept	Father's administrative information Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 92013-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus	S	1..1	Reference(RelatedPerson - Father Natural - Vital Records)	The focus of this section is the father: the "US Standard Patient’s Worksheet for the Report of Fetal Death" should be the source of truth for the father's name, dob, and birthplace.
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:patientsQuestionnaireResponse	C	0..1	BackboneElement	Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		1..1	CodeableConcept	Questionnaire response Document Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 74465-6
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	1..1	Reference(QuestionnaireResponse)	QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Composition.status	required	CompositionStatus
Composition.type	preferred	Pattern: LOINC code 69045-3
Composition.category	example	DocumentClassValueSet
Composition.encounter.type	extensible	ResourceType
Composition.confidentiality	required	v3.ConfidentialityClassification
Composition.attester.mode	required	CompositionAttestationMode
Composition.relatesTo.code	required	DocumentRelationshipType
Composition.event.code	example	ActCode
Composition.section.code	example	DocumentSectionCodes
Composition.section.mode	required	ListMode
Composition.section.orderedBy	preferred	ListOrderCodes
Composition.section.emptyReason	preferred	ListEmptyReasons
Composition.section:motherPrenatal.code	example	Pattern: LOINC code 57073-9
Composition.section:motherPrenatal.mode	required	ListMode
Composition.section:motherPrenatal.orderedBy	preferred	ListOrderCodes
Composition.section:motherPrenatal.emptyReason	preferred	ListEmptyReasons
Composition.section:medicalHealthInformation.code	example	Pattern: LOINC code 55752-0
Composition.section:medicalHealthInformation.mode	required	ListMode
Composition.section:medicalHealthInformation.orderedBy	preferred	ListOrderCodes
Composition.section:medicalHealthInformation.emptyReason	preferred	ListEmptyReasons
Composition.section:fetus.code	example	Pattern: LOINC code 76400-1
Composition.section:fetus.mode	required	ListMode
Composition.section:fetus.orderedBy	preferred	ListOrderCodes
Composition.section:fetus.emptyReason	preferred	ListEmptyReasons
Composition.section:motherInformation.code	example	Pattern: LOINC code 92014-0
Composition.section:motherInformation.mode	required	ListMode
Composition.section:motherInformation.orderedBy	preferred	ListOrderCodes
Composition.section:motherInformation.emptyReason	preferred	ListEmptyReasons
Composition.section:fatherInformation.code	example	Pattern: LOINC code 92013-2
Composition.section:fatherInformation.mode	required	ListMode
Composition.section:fatherInformation.orderedBy	preferred	ListOrderCodes
Composition.section:fatherInformation.emptyReason	preferred	ListEmptyReasons
Composition.section:patientsQuestionnaireResponse.code	example	Pattern: LOINC code 74465-6
Composition.section:patientsQuestionnaireResponse.mode	required	ListMode
Composition.section:patientsQuestionnaireResponse.orderedBy	preferred	ListOrderCodes
Composition.section:patientsQuestionnaireResponse.emptyReason	preferred	ListEmptyReasons

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:fetus, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:motherPrenatal, Composition.section:medicalHealthInformation, Composition.section:fetus, Composition.section:motherInformation, Composition.section:fatherInformation, Composition.section:patientsQuestionnaireResponse	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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 : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()