description: This Composition profile contains constraints to address the use case describing the need for fetal death information to be recorded and communicated to the jurisdictional Vital Records Office.\n\nFor 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 information from these two sources may be communicated to the jurisdictional Vital Records Office at the same time (using this document) or separately (using the Provider Supplied Mother's Fetal Death Reporting Document and the Provider Supplied Facility Fetal Death Reporting Document).\n\nThe data requirements for provider supplied fetal death information are based on the U.S. Standard Report of Fetal Death, the 2004 US Standard Facility Worksheet for the Report of Fetal Death, and the 2004 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.\n\nThe 1992 Revision of the Model State Vital Statistics Act and Regulations recommends the following definition of fetal death:\n> \"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. package_name: hl7.fhir.us.bfdr derivation: constraint name: CompositionProviderFetalDeathReport type: Composition elements: extension: index: 0 slicing: rules: open discriminator: - {path: url, type: value} min: null slices: sliceFetalDeathReportId: match: {url: null} schema: {type: Extension, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-id', index: 1} max: 1 sliceFetalDeathReportFileNumber: match: {url: null} schema: {type: Extension, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-file-number', index: 2} max: 1 type: short: U.S. standard report of fetal death - 2003 revision pattern: type: CodeableConcept value: coding: - {code: 69045-3, system: 'http://loinc.org'} index: 3 subject: type: Reference refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-decedent-fetus'] index: 4 encounter: {mustSupport: true, index: 5} section: short: The Composition is broken into sections that, where possible, align with the sections in the Fetal Death Report. index: 6 slicing: rules: open discriminator: - {path: code, type: pattern} min: null slices: motherPrenatal: match: code: coding: - {code: 57073-9, system: 'http://loinc.org'} schema: short: Mother (prenatal) section on the Fetal Death Report mustSupport: true index: 7 elements: code: short: Prenatal records pattern: type: CodeableConcept value: coding: - {code: 57073-9, system: 'http://loinc.org'} index: 8 focus: type: Reference short: The focus of this section is the mother refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother'] index: 9 entry: short: Entries that are contained in the Mother Prenatal section index: 10 slicing: rules: open ordered: false discriminator: - {path: $this.resolve(), type: profile} min: null slices: dateLastLiveBirth: match: {} schema: short: Date of last live birth refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-date-of-last-live-birth'] type: Reference mustSupport: true index: 20 max: 1 mothersHeight: match: {} schema: short: Mother's height refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-height'] type: Reference mustSupport: true index: 11 max: 1 dateLastNormalMenses: match: {} schema: short: Date last normal menses began refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-last-menstrual-period'] type: Reference mustSupport: true index: 17 max: 1 firstPrenatalCareVisit: match: {} schema: short: First prenatal care visit refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-date-of-first-prenatal-care-visit'] type: Reference mustSupport: true index: 16 max: 1 plannedToDeliverAtHome: match: {} schema: short: Planned to deliver at home refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-planned-to-deliver-at-home'] type: Reference mustSupport: true index: 15 max: 1 numberNowDead: match: {} schema: short: Number of previous live births now dead refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-births-now-dead'] type: Reference mustSupport: true index: 19 max: 1 mothersPrepregnancyWeight: match: {} schema: short: Mother's prepregnancy weight refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-prepregnancy-weight'] type: Reference mustSupport: true index: 12 max: 1 cigaretteSmokingBeforeDuringPregnancy: match: {} schema: short: Cigarettes smoked by the mother before and during the pregnancy refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy'] type: Reference mustSupport: true array: true max: 4 index: 14 max: 4 numberNowLiving: match: {} schema: short: Number of previous live births now living refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-births-now-living'] type: Reference mustSupport: true index: 18 max: 1 motherReceivedWICFood: match: {} schema: short: Use of the WIC nutritional program by the mother refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-mother-received-wic-food'] type: Reference mustSupport: true index: 13 max: 1 motherInformation: match: code: coding: - {code: 92014-0, system: 'http://loinc.org'} schema: short: Mother administrative section on the Fetal Death Report mustSupport: true index: 21 elements: code: short: Mother's administrative information pattern: type: CodeableConcept value: coding: - {code: 92014-0, system: 'http://loinc.org'} index: 22 focus: type: Reference short: The focus of this section is the mother refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother'] index: 23 entry: short: Entries that are contained in the motherInformation section index: 24 slicing: rules: open ordered: false discriminator: - {path: $this.resolve(), type: profile} min: null slices: mothersEducation: match: {} schema: short: Mother's education refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-parent-education-level'] type: Reference mustSupport: true index: 25 max: 1 medicalHealthInformation: match: code: coding: - {code: 55752-0, system: 'http://loinc.org'} schema: short: Medical and Health Informatino section on the Fetal Death Report mustSupport: true index: 26 elements: code: short: Clinical information pattern: type: CodeableConcept value: coding: - {code: 55752-0, system: 'http://loinc.org'} index: 27 focus: type: Reference short: The focus of this section is the mother refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother'] index: 28 entry: short: Entries that are contained in the medical and health information section index: 29 slicing: rules: open ordered: false discriminator: - {path: $this.resolve(), type: profile} min: null slices: pregnancyRiskFactors: match: {} schema: type: Reference short: Risk factors in this pregnancy mustSupport: true refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-pregnancy-risk-factor'] index: 30 numberPreviousCesareans: match: {} schema: short: If mother had a previous cesarean delivery, how many refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-previous-cesareans'] type: Reference mustSupport: true index: 31 max: 1 fetalPresentation: match: {} schema: short: Fetal presentation at birth refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Condition-fetal-presentation'] type: Reference mustSupport: true index: 32 max: 1 finalRouteMethodDelivery: match: {} schema: short: Final route and method of delivery refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Procedure-final-route-method-delivery'] type: Reference mustSupport: true index: 33 max: 1 trialLaborAttempted: match: {} schema: short: If cesearean, was a trial of labor attempted? refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-labor-trial-attempted'] type: Reference mustSupport: true index: 34 max: 1 maternalMorbidity: match: {} schema: type: Reference short: Maternal morbidity (complications associated with labor and delivery) mustSupport: true refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Condition-maternal-morbidity'] index: 35 fetus: match: code: coding: - {code: 76400-1, system: 'http://loinc.org'} schema: short: fetus section on the Fetal Death Report mustSupport: true index: 36 elements: code: short: Fetal delivery information Document [US Standard Report of Fetal Death] pattern: type: CodeableConcept value: coding: - {code: 76400-1, system: 'http://loinc.org'} index: 37 entry: short: Entries that are contained in the fetus section index: 38 slicing: rules: open ordered: false discriminator: - {path: $this.resolve(), type: profile} min: null slices: deliveryWeight: match: {} schema: short: Delivery weight refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-birth-weight'] type: Reference mustSupport: true index: 39 max: 1 gestationalAgeAtDelivery: match: {} schema: short: Obstetric estimate of gestation refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-gestational-age-at-delivery'] type: Reference mustSupport: true index: 40 max: 1 causeOfFetalDeath: match: {} schema: short: Initiating cause or condition of fetal death refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Condition-fetal-death-cause-or-condition'] type: Reference mustSupport: true index: 41 max: 1 otherCauseOfDeath: match: {} schema: type: Reference short: Another significant cause or condition for the death of the fetus. mustSupport: true refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Condition-fetal-death-other-cause-or-condition'] index: 42 autopsyPerformed: match: {} schema: short: An indication if an autopsy has been performed on the subject. refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-autopsy-performed'] type: Reference mustSupport: true index: 43 max: 1 histologicalExamPerformed: match: {} schema: short: Whether or not a histological placental examination was performed. refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-histological-placental-exam-performed'] type: Reference mustSupport: true index: 44 max: 1 autopsyOrHistologicalExamUsed: match: {} schema: short: 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. refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-autopsy-histological-exam-results-used'] type: Reference mustSupport: true index: 45 max: 1 plurality: match: {} schema: short: Plurality - Single, Twin, Triplet, etc. refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-plurality'] type: Reference mustSupport: true index: 46 max: 1 package_version: 0.1.0 extensions: sliceFetalDeathReportId: {url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-id', max: 1, type: Extension, index: 1} sliceFetalDeathReportFileNumber: {url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-file-number', max: 1, type: Extension, index: 2} class: profile kind: resource url: http://hl7.org/fhir/us/bfdr/StructureDefinition/Composition-provider-fetal-death-report base: http://hl7.org/fhir/StructureDefinition/Composition version: 0.1.0 required: [subject]