This page is part of the Vital Records Birth and Fetal Death Reporting (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) 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
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 Present Job-Occupation | Secretary |
| Mother's Present Job-Industry | State Agency |
| Mother's Race and Ethnicity | White/Black/AIAN/Hispanic |
| Father's Present Job-Occupation | Teaching Assistant |
| Father's Present Job-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 |