Notice
- Important: This guidance is under active development by NHS England and content may be added or updated on a regular basis.
- This Implementation Guide is currently in Draft and SHOULD NOT be used for development or active implementation without express direction from the NHS England Genomics Unit.
Fetus
Purpose
To support genetic interpretation of tests and samples for fetuses. To provide a clear divide between mother and fetus and support the management of multiple fetuses.
Notes
Mapped to its own Patient resource, optionally tagged via a proposed birthStatus extension or future dated EDD in place of birthDate, as well as linked observations.
Correct representation of fetal data is under review within the Interoperability Standards Team ans is subject to change
Mapping
| Source Data item | Target FHIR Element | HL7v2.5.1 Mapping | Description |
|---|---|---|---|
| Fetus - Local identifier | Patient.identifier:system != https://fhir.nhs.uk/Id/nhs-number | PID-3 where PID-3.5 = 2.16.840.1.113883.2.1.3.2.4.18.24 | Fetus identification code other than NHS number. |
| Fetus - Observed sex | Patient.gender | PID-8 | Fetus' phenotypic sex classification. Estimated physical characteristic. Currently determined by ultrasound. Gender for PLCM. |
| Fetus - Chromosomal sex | Observation.code( subject=Patient, code = code under 734840008 or 95462004 as examples ) | OBX-5 with appropriate SNOMED/READ/LOINC code | Fetus' genomic / karyotypic characteristic. Determined by genomic testing. |
| Fetus - Are multiple fetuses being tested | N/A Inferred through inclusion of multiple Patient resources attached to test order | N/A inferred though inclusion of multiple NTE segments attached to OML message | Confirmation that multiple fetuses are being tested. |
| Fetus - Is testing for fetal loss from 24 weeks of gestation | Inferred through inclusion observation/condition for fetal loss (code under 363681007) with date later than 24 weeks after pregnancy observation | Inferred though difference in OBX-14 for pregnancy and miscarriage/loss observations | Confirmation that the test is for a loss of pregnancy after 24 weeks gestation. |
| Fetus - Life status at time of request | For Foetal records, foetal death SHOULD be recorded through the Patient.extension:bornStatus field. The type of death can be inferred through Observation components related to the mother's pregnancy observation. | PID-30 (OBX segments should be used for types of fetal death) | Fetus' alive or deceased status details at the point of test ordering. |