| ARCHETYPE ID | openEHR-EHR-EVALUATION.obstetric_summary.v1 |
|---|---|
| Concept | Obstetric summary |
| Description | An overview of the obstetric history of a woman, including a summary of all pregnancies and the associated outcomes or interventions. |
| Use | Use to record an overview of the obstetric history of a woman, including a summary of all pregnancies and the associated outcomes or interventions. Use this summary as the basis of statutory reporting regarding births. Use to record the TPAL overview of an obstetric history, if required - the numbers of Term Births (T), Preterm Births (P), Abortions (A) and Living Children (L). Some variations add Gravidity (G) and number of Multiple Births (M). Some data may be calculated or derived from individual pregnancy records if these are available. |
| Misuse | Not for recording summary information about a specific pregnancy - use EVALUATION. pregnancy_summary for this purpose. Not for recording detailed information about each of the individual pregnancies, miscarriages, terminations, or deliveries. This information will be recorded using other specific archetypes as event-based data. |
| Purpose | To record an overview about the obstetric history of a woman for purposes of: providing a snapshot of her obstetric history, reporting to statutory bodies or supporting clinical decision support. |
| References | |
| Copyright | © openEHR Foundation |
| Authors | Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2011-02-24 |
| Other Details Language | Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2011-02-24 |
| Other Details (Language Independent) |
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| Keywords | obstetric, pregnancy, parity, gravida, para, terminations, miscarriages, abortions, spontaneous, live, births, stillbirths, caesarean, ectopic, neonatal, tubal, living, multiple, neonatal death |
| Lifecycle | AuthorDraft |
| Language used | en |
| Citeable Identifier | 1013.1.1312 |
| protocol | |
| Date Updated | Date Updated: The date this summary was last updated. |
| Stillbirth Definition | Stillbirth Definition: Definition of stillbirth. Maybe useful to record when comparing data from different regions as, as definitions of stillbirth may vary. For example, in Australia a stillborn baby will have a gestation greater than 20 weeks or, if gestation is unknown, weigh more than 400 grams. |
| data | |
| Pregnancies | Pregnancies: Number of times a woman has been pregnant, including a current pregnancy. May also be referred to as Gravidity. Using the GTPALM approach, this data element corresponds to Gravidity - 'G'. min: >=0; max: <100 |
| Births | Births: Number of times a woman has given birth after 20 weeks gestation, to one or more babies. May also be referred to as Parity. Late terminations of pregnancy (after 20 weeks of gestation) are not included. When both 'Term Births (T)' and 'Preterm Births (P)' are recorded, 'Parity' should be equal to their sum. Note: Parity is not the equivalent to the number of infants born - for example, birth of twins would be recorded in this data point as one birth event. min: >=0 |
| Term Births | Term Births: Number of birth events in which the babies are born on or after 37 weeks of gestation. Using the GTPALM approach, this data element corresponds to Term Births - 'T'. |
| Preterm Births | Preterm Births: Number of birth events in which the babies are born at less than 37 weeks of gestation. Using the GTPALM approach, this data element corresponds to Preterm Births - 'P'. |
| Multiple Births | Multiple Births: Number of birth events in which more than one baby has been born. Using the GTPALM approach, this data element corresponds to Multiple Births - 'M'. |
| Abortions | Abortions: Number of non-viable pregnancies from all causes and at any gestation, including spontaneous miscarriages, induced terminations and ectopic pregnancies. When all of 'Miscarriages', 'Terminations' and 'Ectopic Pregnancies' are recorded, this number should be equal to their sum. Using the GTPALM approach, this data element corresponds to Abortions - 'A'. |
| Miscarriages | Miscarriages: Number of times a woman has had a spontaneous miscarriage at less than 20 weeks of gestation. Including missed abortions. min: >=0 |
| Terminations | Terminations: Number of times a woman has had an induced pregnancy termination, regardless of gestation. min: >=0 |
| Ectopic Pregnancies | Ectopic Pregnancies: Number of ectopic pregnancies. |
| Caesarean Sections | Caesarean Sections: Number of Caesarean sections performed. min: >=0 |
| Stillborn | Stillborn: Number of stillborn babies from all birth events. Note: The definition of Stillbirth may be optionally captured in specific data element in Protocol. |
| Liveborn | Liveborn: Number of liveborn babies from all birth events. min: >=0 |
| Living Children | Living Children: Number of children who remain alive at the time of data recording. Using the GTPALM approach, this data element corresponds to Living Children - 'L'. min: >=0 |
| Adopted Children | Adopted Children: Number of children who have been adopted. |
| Clinical Description | Clinical Description: Narrative description about the obstetric history, including significant aspects that might be useful for sharing or for triggering further investigation. For example, complications, delivery interventions, IVF treatment etc. |
| Other contributors | Sheryl Alexander, NT Department of Health, Australia Rita Apelt, Department of Health,NT, Australia Stephen Chu, NEHTA, Australia Margaret Cotter, AMSANT, Australia Michelle Dowden, Miwatj Health Ngalkanbuy Health, Australia Tim Garden, NTG Department of Health, Australia Tanya Gardner, CAAC, Australia Sam Heard, Ocean Informatics, Australia (Editor) Oliver Hosking, Remote Health NT, Australia Michelle Kealy, Australia Bernadette Lack, Department of Health, Australia Heather Leslie, Ocean Informatics, Australia (Editor) Hugh Leslie, Ocean Informatics, Australia Chunlan Ma, Ocean Informatics, Australia Ian McNicoll, Ocean Informatics UK, United Kingdom Jeremy Oats, NT Health, Australia Steven Schatz, Department of Health (Northern Territory), Australia Rosalie Schultz, Anyinginyi Health Aboriginal Corporation, Australia Gary Sinclair, NT DoH, Australia Cherie Whitbread, Royal Darwin Hospital, Australia Jo Wright, NT Dept of Health, Australia (Editor) |
| Translators |