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.
package_name: hl7.fhir.us.bfdr
derivation: constraint
name: CompositionProviderFetalDeathReport
type: Composition
elements:
  extension:
    mustSupport: true
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: url, type: value}
      min: 1
      slices:
        fetalDeathReportNumber:
          match: {url: null}
          schema: {type: Extension, short: State File Number, mustSupport: true, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-number', index: 1}
          min: 0
          max: 1
        fetalDeathLocalFileNumber:
          match: {url: null}
          schema: {type: Extension, short: Local File No., mustSupport: true, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-local-file-number', index: 2}
          max: 1
        dateReceivedByRegistrar:
          match: {url: null}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-date-received-by-registrar', index: 3}
          min: 1
          max: 1
        replacementStatus:
          match: {url: null}
          schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-replacement-status', index: 4}
          max: 1
  status: {short: 'In the case of a fetal death sent in error, a status of ''entered-in-error'' must be set.', mustSupport: true, index: 5}
  type:
    short: U.S. standard report of fetal death - 2003 revision
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 69045-3, system: 'http://loinc.org'}
    index: 6
  subject:
    type: Reference
    short: '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.'
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-decedent-fetus-vr']
    index: 7
  encounter:
    type: Reference
    short: The Encounter for the Composition is the mother's maternity encounter.
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Encounter-maternity']
    index: 8
    extensions: {}
    elements:
      extension: {type: Extension, url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-encounter-maternity-reference', index: 9}
  date: {short: Date report completed, mustSupport: true, index: 10}
  author:
    type: Reference
    short: The author is the person who verifies/approves the accuracy of the data to be sent to the vital records system.
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Practitioner-vr']
    index: 11
  section:
    short: The Composition is broken into sections that, where possible, align with the sections in the Fetal Death Report.
    mustSupport: true
    index: 12
    slicing:
      rules: open
      discriminator:
      - {path: code, type: pattern}
      min: 1
      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: 13
            elements:
              code:
                short: Prenatal records
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 57073-9, system: 'http://loinc.org'}
                index: 14
              focus:
                type: Reference
                short: '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.'
                mustSupport: true
                refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr']
                index: 15
              entry:
                short: Entries that are contained in the Mother Prenatal section
                mustSupport: true
                index: 16
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this.resolve(), type: profile}
                  min: 1
                  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: 22
                      max: 1
                    mothersHeight:
                      match: {}
                      schema:
                        short: '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.'
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-height-vr']
                        type: Reference
                        mustSupport: true
                        index: 23
                      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-vr']
                        type: Reference
                        mustSupport: true
                        index: 19
                      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: 18
                      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: 17
                      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-vr']
                        type: Reference
                        mustSupport: true
                        index: 21
                      max: 1
                    mothersPrepregnancyWeight:
                      match: {}
                      schema:
                        short: '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.'
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-mother-prepregnancy-weight-vr']
                        type: Reference
                        mustSupport: true
                        index: 24
                      max: 1
                    cigaretteSmokingBeforeDuringPregnancy:
                      match: {}
                      schema:
                        short: '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.'
                        refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-cigarette-smoking-before-during-pregnancy']
                        type: Reference
                        mustSupport: true
                        array: true
                        max: 4
                        index: 26
                      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-vr']
                        type: Reference
                        mustSupport: true
                        index: 20
                      max: 1
                    motherReceivedWICFood:
                      match: {}
                      schema:
                        short: '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.'
                        refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-mother-received-wic-food']
                        type: Reference
                        mustSupport: true
                        index: 25
                      max: 1
            required: [entry, focus, code]
        medicalHealthInformation:
          match:
            code:
              coding:
              - {code: 55752-0, system: 'http://loinc.org'}
          schema:
            short: Medical and Health Information section on the Fetal Death Report
            mustSupport: true
            index: 27
            elements:
              code:
                short: Clinical information
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 55752-0, system: 'http://loinc.org'}
                index: 28
              focus:
                type: Reference
                short: The focus of this section is the mother
                mustSupport: true
                refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr']
                index: 29
              entry:
                short: Entries that are contained in the medical and health information section
                mustSupport: true
                index: 30
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this.resolve(), type: profile}
                  min: 1
                  slices:
                    pregnancyRiskFactors:
                      match: {}
                      schema:
                        type: Reference
                        short: Risk factors in this pregnancy
                        mustSupport: true
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-eclampsia-hypertension-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-gestational-diabetes-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-gestational-hypertension-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-prepregnancy-diabetes-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Condition-prepregnancy-hypertension-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-none-of-specified-pregnancy-risk-factors-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-previous-cesarean-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-previous-preterm-birth-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Procedure-artificial-insemination-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Procedure-assisted-fertilization-vr', 'http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Procedure-infertility-treatment-vr']
                        index: 31
                    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-vr']
                        type: Reference
                        mustSupport: true
                        index: 32
                      max: 1
                    fetalPresentation:
                      match: {}
                      schema:
                        short: Fetal presentation at birth
                        refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-fetal-presentation']
                        type: Reference
                        mustSupport: true
                        index: 33
                      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: 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-perineal-laceration', 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Condition-ruptured-uterus', 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-icu-admission', 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-none-of-specified-maternal-morbidities', 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Procedure-blood-transfusion', 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Procedure-unplanned-hysterectomy']
                        index: 35
            required: [entry, focus, code]
        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]
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 76400-1, system: 'http://loinc.org'}
                index: 37
              entry:
                short: Entries that are contained in the fetus section
                mustSupport: true
                index: 38
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this.resolve(), type: profile}
                  min: 1
                  slices:
                    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: 45
                      max: 1
                    numberLiveBirthsThisDelivery:
                      match: {}
                      schema:
                        type: Reference
                        short: Number of live births this delivery
                        mustSupport: true
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-live-births-this-delivery-vr']
                        index: 47
                      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-vr']
                        type: Reference
                        mustSupport: true
                        index: 40
                      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
                    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
                    estimatedTimeFetalDeath:
                      match: {}
                      schema:
                        short: The estimated time of fetal death; the time of death is characterized by the relationship to the time of delivery.
                        refers: ['http://hl7.org/fhir/us/bfdr/StructureDefinition/Observation-estimated-fetal-death-time-point']
                        type: Reference
                        mustSupport: true
                        _required: true
                        index: 43
                      min: 1
                      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: 46
                      max: 1
                    deliveryWeight:
                      match: {}
                      schema:
                        short: Delivery weight
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-birth-weight-vr']
                        type: Reference
                        mustSupport: true
                        index: 39
                      max: 1
                    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-indicator-vr']
                        type: Reference
                        mustSupport: true
                        index: 44
                      max: 1
                    numberFetalDeathsThisDelivery:
                      match: {}
                      schema:
                        type: Reference
                        short: Number of fetal deaths this delivery
                        mustSupport: true
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-number-fetal-deaths-this-delivery-vr']
                        index: 48
                      max: 1
            required: [entry, code]
        motherInformation:
          match:
            code:
              coding:
              - {code: 92014-0, system: 'http://loinc.org'}
          schema:
            short: Mother administrative section on the Fetal Death Report
            mustSupport: true
            index: 49
            elements:
              code:
                short: Mother's administrative information
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 92014-0, system: 'http://loinc.org'}
                index: 50
              focus:
                type: Reference
                short: The focus of this section is the mother
                mustSupport: true
                refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Patient-mother-vr']
                index: 51
              entry:
                short: Entries that are contained in the motherInformation section
                mustSupport: true
                index: 52
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this.resolve(), type: profile}
                  min: 1
                  slices:
                    mothersEducation:
                      match: {}
                      schema:
                        short: '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.'
                        refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/Observation-parent-education-level-vr']
                        type: Reference
                        mustSupport: true
                        index: 53
                      max: 1
            required: [entry, focus, code]
        fatherInformation:
          match:
            code:
              coding:
              - {code: 92013-2, system: 'http://loinc.org'}
          schema:
            short: Father section on the Fetal Death Report
            mustSupport: true
            index: 54
            elements:
              code:
                short: Father's administrative information
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 92013-2, system: 'http://loinc.org'}
                index: 55
              focus:
                type: Reference
                short: '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.'
                mustSupport: true
                refers: ['http://hl7.org/fhir/us/vr-common-library/StructureDefinition/RelatedPerson-father-natural-vr']
                index: 56
            required: [focus, code]
        patientsQuestionnaireResponse:
          match:
            code:
              coding:
              - {code: 74465-6, system: 'http://loinc.org'}
          schema:
            short: Optional section containing a QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
            index: 57
            elements:
              code:
                short: Questionnaire response Document
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 74465-6, system: 'http://loinc.org'}
                index: 58
              entry:
                type: Reference
                short: QuestionnaireResponse with recorded answers to the Questionnaire - Patient's Worksheet for Fetal Death Report
                refers: ['http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse']
                index: 59
            required: [entry, code]
package_version: 1.1.0
extensions:
  fetalDeathReportNumber: {url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-report-number', min: 0, max: 1, type: Extension, short: State File Number, mustSupport: true, index: 1}
  fetalDeathLocalFileNumber: {url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-fetal-death-local-file-number', max: 1, type: Extension, short: Local File No., mustSupport: true, index: 2}
  dateReceivedByRegistrar: {url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-date-received-by-registrar', min: 1, max: 1, type: Extension, mustSupport: true, index: 3}
  replacementStatus: {url: 'http://hl7.org/fhir/us/bfdr/StructureDefinition/Extension-replacement-status', max: 1, type: Extension, mustSupport: true, index: 4}
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: 1.1.0
required: [extension, section, subject]