Extract By Encounter Type Encounter: Antenatal Specialty Data Element Name BORN ID Data Element Definition Pick List Value Pick List Definition Alcohol Exposure in Pregnancy D0012 Self-reported alcohol consumption during pregnancy. A standardized serving of alcohol beverage is approx a 12oz serving of regular beer (5%), a 5oz glass of wine (12%) or a 1.5oz glass of 40% spirit (SOGC, 2010). If the amount of drinking varied over the course of the pregnancy, estimate the total number of drinks and average it out over the entire pregnancy. Select the one that represents the highest exposure or impact. 'Episodic excessive drinking (binging)'is considered the greatest impact. None Less than one drink per month One drink per month 2-3 drinks per month One drink per week More than one drink per week Episodic excessive drinking (binging) Binge drinking corresponds to an average-size female consuming 4 or more drinks in about 2 hours (SOGC, 2010). If mother reported drinking 'More than one drink per week' and binge drinking, select "Episodic excessive drinking (binging)'. Exposure prior to pregnancy confirmed, amount unknown Select if mother drank in first trimester and/or until she learned of her pregnancy. Unknown Chorionicity CHORION 1 chorion 2 chorion 3 chorion 4 chorion Unknown Complications of Pregnancy M0531 Pregnancy related complications experienced during this pregnancy. Select all that apply. None August 13, 2019 Page 1 of 142
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Extract By Encounter Type
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Alcohol Exposure in Pregnancy
D0012 Self-reported alcohol consumption during pregnancy. A standardized serving of alcohol beverage is approx a 12oz serving of regular beer (5%), a 5oz glass of wine (12%) or a 1.5oz glass of 40% spirit (SOGC, 2010). If the amount of drinking varied over the course of the pregnancy, estimate the total number of drinks and average it out over the entire pregnancy. Select the one that represents the highest exposure or impact. 'Episodic excessive drinking (binging)'is considered the greatest impact.
None
Less than one drink per month
One drink per month
2-3 drinks per month
One drink per week
More than one drink per week
Episodic excessive drinking (binging) Binge drinking corresponds to an average-size female consuming 4 or more drinks in about 2 hours (SOGC, 2010). If mother reported drinking 'More than one drink per week' and binge drinking, select "Episodic excessive drinking (binging)'.
Exposure prior to pregnancy confirmed, amount unknown
Select if mother drank in first trimester and/or until she learned of her pregnancy.
Unknown
Chorionicity CHORION 1 chorion
2 chorion
3 chorion
4 chorion
Unknown
Complications of Pregnancy
M0531 Pregnancy related complications experienced during this pregnancy. Select all that apply.
None
August 13, 2019 Page 1 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Complications of Pregnancy
M0531 Pregnancy related complications experienced during this pregnancy. Select all that apply.
Fetal \ Anomaly(ies)
Fetal \ Isoimmunization/Alloimmunization
Fetal \ Intrauterine Growth Restriction
Fetal \ LGA
Fetal \ Oligohydramnios
Fetal \ Polyhydramnios
Fetal \ Other
Maternal \ Anemia unresponsive to therapy
Maternal \ Antepartum Bleeding (Persistent and unexplained)
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Cytogenetic Testing Disease Identifier
FAN1006ODI The chromosome region that was interrogated for deletion or duplication by FISH
1q21.1 duplication
3q29 duplication
7q11.23 duplication
15q11-13 duplication
15q13.2-13.3 duplication
16p13.11 duplication
17p11.2 duplication
17q21.31 duplication
Other, free text:
Unknown
Cytogenetic Testing Disease Identifier Other
FAN1006ODIOTHER The name of the disease / region of the genome (in ISCN nomenclature) that was interrogated for deletion or duplication by FISH entered in free text
Cytogenetic Testing Method Performed
FAN1006 The method used to interrogate the individuals genome for imbalances or rearrangements
Karyotype
Microarray
Cytogenetic testing result specific
FAN1008 The result, in general terms, of the cytogenetic test performed
10p13-p14 deletion / velocardiofacial 2
11p15.5 deletion / Beckwith-Wiedemann syndrome
15q11-13 duplication
15q13.2-13.3 duplication
16p13.11 duplication
17p11.2 duplication
17q21.31 duplication
1p36 deletion syndrome
1q21 deletion / thrombocytopenia absent radius
August 13, 2019 Page 4 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Cytogenetic testing result specific
FAN1008 The result, in general terms, of the cytogenetic test performed
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Cytogenetic testing result specific
FAN1008 The result, in general terms, of the cytogenetic test performed
Marker chromosome
Mosaicism, specify:
Specify
Translocation, balanced
Translocation, unbalanced
Trisomy 13, mosaic
Trisomy 16, mosaic
Trisomy 18, mosaic
Xp22.31 deletion / X-linked ichthyosis
Xq28 duplication / MECP2 duplication MR syndrome
Other, free text:
Unknown
Cytogenetic testing result specific Other (free text in ISCN nomenclature)
FAN1009 The detailed results of the cytogenetic test performed in ISCN nomenclature when the result is not available in the pick list. For example, 45, XX, rob(13;21)(q10;q10) (balanced Robertsonian translocation) or arr cgh 22q11.2(D22S75)X1 (abnormal microarray)
Date of First Abnormal U/S
FAN0022 Date of first ultrasound yielding abnormal results in standard date format.
Date of First Tertiary(High Risk) Centre Ultrasound
FAN0015 Date of first high-risk centre ultrasound in standard date format.
Date of First Visit to FMU NEW0010 Date of visit with Fetal Medicine Unit in current pregnancy using standard date format.
Date of First Visit to FMU Is Unknown
NEW0010UN Indicates that the date of first visit to Fetal Medicine Unit is unknown
Date of First Visit to Prenatal Genetics
FAN0020 Date of mother's first visit to prenatal genetics unit in current pregnancy
August 13, 2019 Page 6 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Date of First Visit to Prenatal Genetics Is Unknown
FAN0020UN Indicates that the date of mother's first visit to prenatal genetics unit is unknown
Date of Referral to Prenatal Genetics
NEW0007-1 Indicates date when mother was referred to prenatal genetics during current pregnancy.
Date of Referral to Prenatal Genetics Is Unknown
NEW0007-1UN Indicates that the date when mother was referred to prenatal genetics is unknown
Date prenatal PRBC transfusion
D0072 The date that the prenatal (in utero) PRBC transfusion was performed (if there were multiple performed, enter the most recent)
Diabetes and Pregnancy D0013 Indicate Maternal diabetic status during this pregnancy Diabetes Complications/Comorbidities \ Nephropathy
Gestational diabetes \ Insulin \ No Ace Inhibitors or Statins
Gestational diabetes \ No Insulin \ No Oral agents
Gestational diabetes \ No Insulin \ Oral Antihyperglycemic Agents
Gestational diabetes \ Insulin Status Unknown
Type I
Type II \ Insulin \ ACE inhibitors
Type II \ Insulin \ Statins
Type II \ Insulin \ No Ace Inhibitors or Statins
Type II \ No Insulin \ No Oral Agents
Type II \ No Insulin \ Oral Antihyperglycemic Agents
Type Unknown
August 13, 2019 Page 7 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Diabetes and Pregnancy D0013 Indicate Maternal diabetic status during this pregnancy Unknown
Drug and Substance Exposure in Pregnancy
D0014 Indicate Maternal self-reported drug and substance use during pregnancy. This refers to the use of street drugs and the inappropriate use of prescription and non-prescription drugs.
None
Cocaine Street names include: snow, powder lines, freebase, c, dust, crack, rock, coke, flake, blow.
Gas/Glue
Hallucinogens Types of hallucinogens include: LSD, mescaline, psilocybin, PCP, cannabis, ecstasy, ketamine, salvia and others.
Opioids A type of drug used to relieve pain. Examples include: morphine, codeine, fentanyl, oxycodone, heroin, and hydromorphone.
Other For example, crystal meth
Unknown
Early Pregnancy/Detailed Anatomy Scan Date
FAN0010-1 Date of scan
Early Pregnancy/Detailed Anatomy Scan GA
FAN0010-2 GA at the time of scan
Early Pregnancy/Detailed Anatomy Scan Location
FAN0010-4 Location of scan Community ultrasound department
Tertiary centre or FMU unit
Unknown
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Normal - no anomaly detected
Abdominal Wall \ Bladder exstrophy
Abdominal Wall \ Cloacal exstrophy
Abdominal Wall \ Gastroschisis
Abdominal Wall \ Limb body wall complex (body stalk anomaly)
August 13, 2019 Page 8 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Abdominal Wall \ Not well seen
Abdominal Wall \ Omphalocele (exomphalos)
Abdominal Wall \ Other congenital malformations of abdominal wall
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Cardiovascular \ Cardiomyopathy - dilated
Cardiovascular \ Cardiomyopathy - fetus of diabetic mother
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Cardiovascular \ Echogenic intracardiac focus - Not otherwise specified
Cardiovascular \ Ectopia cordis
Cardiovascular \ Endocardial fibroelastosis (EFE)
Cardiovascular \ Fibroma - cardiac
Cardiovascular \ Hypoplastic left heart syndrome (HLHS)
Cardiovascular \ Hypoplastic right heart syndrome (HRHS)
Cardiovascular \ Premature closure of atrial septum (PFO)
August 13, 2019 Page 11 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Cardiovascular \ Right atrial isomerism (heterotaxy)
Cardiovascular \ Scimitar syndrome
Cardiovascular \ Shone's syndrome
Cardiovascular \ Single outlet ventricle
Cardiovascular \ Single ventricle (univentricular heart)
Cardiovascular \ Situs inversus - cardiac
Cardiovascular \ Subaortic stenosis
Cardiovascular \ Supra ventricular tachycardia (SVT)
Cardiovascular \ Tachycardia (tachyarrhythmia)
Cardiovascular \ Tetralogy of Fallot (TOF)
Cardiovascular \ Total anomalous pulmonary venous drainage (TAPVD)
Cardiovascular \ Tricuspid atresia
Cardiovascular \ Transposition of great arteries - congenitally corrected (CCTGA)
Cardiovascular \ Transposition of great vessels (TGA)
Cardiovascular \ Tricuspid Valve regurgitation
August 13, 2019 Page 12 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Face \ MOUTH-Cleft palate
Face \ MOUTH-Flat face
Face \ MOUTH-Macroglossia
Face \ MOUTH-Micrognathia
Face \ MOUTH-Mouth - abnormal/other
Face \ MOUTH-Retrognathia
Face \ NOSE-Absent nose
Face \ NOSE-Hypoplastic nasal bone (NB)
Face \ NOSE-Absent nasal bone (NB)
Face \ NOSE-Choanal atresia
Face \ NOSE-Nose - abnormal/other
Face \ NOSE-Proboscis
Face \ NOSE-Single nostril
Face \ Other - malformations of the face
Face \ Frontomaxillary Facial Angle - Abnormal
Face \ Tumour of face
Face \ Not well seen
Gastrointestinal \ Bowel obstruction small or large intestine
Gastrointestinal \ Absent (not visible) stomach
Gastrointestinal \ Absent gallbladder
Gastrointestinal \ Adrenal cyst(s)
Gastrointestinal \ Ascites
Gastrointestinal \ Asplenia
August 13, 2019 Page 16 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Gastrointestinal \ Biliary atresia
Gastrointestinal \ Choledochal cyst(s)
Gastrointestinal \ Dilated Bowel
Gastrointestinal \ Dilated gallbladder
Gastrointestinal \ Dilated stomach
Gastrointestinal \ Double bubble
Gastrointestinal \ Duodenal atresia
Gastrointestinal \ Echogenic bowel - grade I (less bright than bone)
Gastrointestinal \ Echogenic bowel - grade II (as bright as bone)
Gastrointestinal \ Echogenic bowel - grade III (brighter than bone)
Gastrointestinal \ Echogenic foci in abdomen
Gastrointestinal \ Echogenic foci in liver
Gastrointestinal \ Esophageal atresia
Gastrointestinal \ Esophageal diverticulum
Gastrointestinal \ Hepatomegaly
Gastrointestinal \ Hirschsprung's disease
Gastrointestinal \ Hyperperistalsis
Gastrointestinal \ Intra-abdominal cyst(s)
Gastrointestinal \ Liver cyst(s)
Gastrointestinal \ Liver nodule
Gastrointestinal \ Meconium ileus
Gastrointestinal \ Meconium peritonitis
Gastrointestinal \ Mesenteric cyst
August 13, 2019 Page 17 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Gastrointestinal \ Not well seen
Gastrointestinal \ Other - malformations of the gastro-intestinal tract
Genitourinary tract \ Duplex kidney/collecting system
Genitourinary tract \ Echogenic kidney(s)
Genitourinary tract \ Ectopic/pelvic kidney
Genitourinary tract \ Horseshoe Kidney
August 13, 2019 Page 18 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Genitourinary tract \ Hydrocoele
Genitourinary tract \ Hydronephrosis (>10 mm)- Right
Genitourinary tract \ Hydronephrosis (>10 mm)- Left
Genitourinary tract \ Pyelectasis (pelviectasis) (5 - 9.9 mm AP diameter)
Genitourinary tract \ Pyelectasis (pelviectasis) (5 - 9.9 mm AP diameter)- Right
Genitourinary tract \ Pyelectasis (pelviectasis) (5 - 9.9 mm AP diameter) - Left
August 13, 2019 Page 19 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Genitourinary tract \ Pyelectasis (pelviectasis) (5 - 9.9 mm AP diameter) - Bilateral
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Head-Cranium & Brain \ Lissenchephaly
Head-Cranium & Brain \ Macrocephaly
Head-Cranium & Brain \ Megalencephaly
Head-Cranium & Brain \ Microcephaly
Head-Cranium & Brain \ Not well seen
Head-Cranium & Brain \ Other - malformations of the head & brain
Head-Cranium & Brain \ Plagiocephaly
Head-Cranium & Brain \ Porencephalic cyst(s)
Head-Cranium & Brain \ Posterior fossa cyst
Head-Cranium & Brain \ Prominent forehead
Head-Cranium & Brain \ Prominent occiput
Head-Cranium & Brain \ Septo-optic dysplasia
Head-Cranium & Brain \ Small cerebellum
Head-Cranium & Brain \ Strawberry shaped head
Head-Cranium & Brain \ Subarachnoid haemorrhage
Head-Cranium & Brain \ Vein of Galen aneurysm/malformation
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Spine / Back \ NTD (neural tube defect) with hydrocephalus
Spine / Back \ NTD (neural tube defect) without hydrocephalus
Spine / Back \ Not well seen
Spine / Back \ Other - malformations of the spine
Spine / Back \ Sacral agenesis
Spine / Back \ Sacrococcygeal teratoma (SCT)
Spine / Back \ Sirenomelia
Structural-other \ Amniotic Bands
August 13, 2019 Page 23 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Structural-other \ Body stalk anomaly
Structural-other \ Hydrops Fetalis
Structural-other \ Not well seen
Structural-other \ Other - malformations not classified elsewhere
Structural-other \ Two vessel cord - Unspecified
Structural-other \ Two vessel cord - Right Artery Absent
Structural-other \ Two vessel cord - Left Artery Absent
Thorax \ Agenesis of lung
Thorax \ Bronchopulmonary sequestration (BPS)
Thorax \ Chest wall deformity
Thorax \ Congenital cystic adenomatoid malformation of lung (CCAML)
Thorax \ Congenital diaphragmatic hernia (CDH)
Thorax \ Congenital high airway obstruction (CHAOS)
Thorax \ Echogenic lung(s)
Thorax \ Eventration of diaphragm
Thorax \ Lung cysts-other
Thorax \ Not well seen
Thorax \ Other - congenital malformations of lung
Thorax \ Other congenital malformations of diaphragm
Thorax \ Pectus carinatum
Thorax \ Pectus excavatum
Thorax \ Pleural effusion(s) (hydrothorax) - >3mm
August 13, 2019 Page 24 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Thorax \ Pleural effusion(s) (hydrothorax) - Right
Other Soft Markers / Obstetrical Imaging Findings \ Polyhydramnios - Severe
August 13, 2019 Page 25 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
Other Soft Markers / Obstetrical Imaging Findings \ Oligohydramnios - Not Othewise Specified
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Early Pregnancy/Detailed Anatomy Scan Result
FAN0010 Ultrasound scan for direct visualization of fetal structures for the purposes of monitoring fetal growth and detecting/monitoring congenital anomalies.
F0001 Best estimate of date of birth determined by ultrasound or mathematical calculation using Nägele's rule. Same as EDC and EDD. EDB is the preferred term.
Fetal Anomalies Confirmed
D0023 Identifies congenital anomalies that were confirmed prenatally
None No anomalies are suspected or confirmed.
Head-Cranium & Brain \ Absent cerebellar vermis
Head-Cranium & Brain \ Absent cerebellum
Head-Cranium & Brain \ Acrania
Head-Cranium & Brain \ Agenesis of corpus callosum (ACC)
Head-Cranium & Brain \ Anencephaly
Head-Cranium & Brain \ Aqueductal stenosis
Head-Cranium & Brain \ Arachnoid cyst(s)
August 13, 2019 Page 27 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Fetal Anomalies Confirmed
D0023 Identifies congenital anomalies that were confirmed prenatally
Head-Cranium & Brain \ Arhinencephaly
Head-Cranium & Brain \ Arnold Chiari malformation
Head-Cranium & Brain \ Atresia of foramina of Magendie & Luschka
Unknown More information is needed and/or there is no documentation to indicate whether or not any congenital anomalies are suspected or confirmed.
August 13, 2019 Page 77 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Fetal Therapy FAN0013 Fetal procedures or surgical interventions that were performed on the fetus during this pregnancy, including endoscopic surgical approaches and pharmacological therapy
None
Amnioinfusion
Amnioreduction
Fetal Drug Therapy
Fetal Surgery
Intrauterine Transfusion \ Packed Red Blood Cells
Intrauterine Transfusion \ Platelets
Laser ablation of placenta
Lower Urinary Tract Obstruction (LUTO) \ Bladder tap
Lower Urinary Tract Obstruction (LUTO) \ Shunt
Maternal Transplacental Drug Therapy
Pleural effusion \ Aspiration
Pleural effusion \ Shunt
Radio frequency ablation
Selective Reduction \ Discordant for anomaly
Selective Reduction \ Higher order multiples
Selective Reduction \ other
Other
Unknown
Fetus ID PS0011 Fetal ID of a multiple pregnancy Fetus A
Fetus B
Fetus C
August 13, 2019 Page 78 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Fetus ID PS0011 Fetal ID of a multiple pregnancy Fetus D
Fetus E
Fetus F
Fetus G
Fetus H
Fetus I
Fetus J
Final Diagnosis Confirmed By
FAN0031 How Fetal or Neonatal Congenital Anomalies were diagnosed
Autopsy
DNA testing
Physical examination
Chromosome analysis
Chromosome analysis – blood
Chromosome analysis – products of conception
Chromosome analysis – biopsy
Chromosome analysis - autopsy
Chromosome analysis - unknown
TORCH
Diagnostic imaging (Xray, CT, MRI)
Biopsy
Not confirmed
Antenatal U/S Only
CGH micro array
QF-PCR (prenatal)
August 13, 2019 Page 79 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Final Diagnosis Confirmed By
FAN0031 How Fetal or Neonatal Congenital Anomalies were diagnosed
Other
First Trimester Visit M0046 Indication that mother had a prenatal care visit with a regulated health care provider during the first trimester (<13 weeks and 0 days gestation of pregnancy) of the current pregnancy.
Folic Acid D0020 Maternal use of folic acid prior to and during pregnancy None
Pre-conception only
During pregnancy only
Preconception and during pregnancy
Unknown
GA at First Abnormal U/S FAN0025 Gestational Age at first ultrasound yielding abnormal results in standard GA format.
GA at First Tertiary U/S FAN0026 Gestational Age at first ultrasound done at a high-risk centre in standard GA format.
GA at first visit to FMU FAN0027 GA at first visit with Fetal Medicine Unit in current pregnancy using GA format. Stored in days
GA at first visit to PNU/MG
FAN0030
Generic Comment D0021 Hospital specific comment
Genetic testing molecular result detail
ASGENTSTD Genetic testing molecular result detail c.1274_1277dupTATC or c.1278insTATC
c.1421+1G>C or IVS12(+1)G>C
c.805G>A (or G269S)
c.433-2A>G
c.693C>A (or Y231X)
c.854A>C (or E285A)
c.914C>A (or A305E)
c.2881del6/ins7 or (Y736)
August 13, 2019 Page 80 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Genetic testing molecular result detail
ASGENTSTD Genetic testing molecular result detail c.2204+6T>C (or R696P)
IVS20(+6)T>C
c.67delG+c.37C>T or c.322delG
IVS3(-2)A>G (or G116_N152del)
c.511_6943del (or 6.4kb deletion)
c.406-2A>G or IVS3(-2)A>G
c.911T>C (or L302P)
c.996delC (or 1bp delfsP330)
c.1493G>T (or R496L)
c.1828_1830del (or delta R608)
c.1521_1523delCTT (or dF508)
45-54
55-59
60-69
70-79
80-89
90-99
100-109
110-119
120-129
130-139
140-200
50-149
150-1000
August 13, 2019 Page 81 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Genetic testing molecular result detail
ASGENTSTD Genetic testing molecular result detail >2000
Other
Other, specify
Unknown
Gestational Age At Scan F0016SC
Gravida (G) M0030 Indicates number of pregnancies the women has experienced, including current pregnancy
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
August 13, 2019 Page 82 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Gravida (G) M0030 Indicates number of pregnancies the women has experienced, including current pregnancy
19
20
21
22
23
24
25
Unknown
HOSP Name ORGHOSP001 Hospital Site Name
Hypertension Disorder in Pregnancy
D0016 Identification of all hypertensive conditions and the progression of hypertensive conditions the women experienced during this pregnancy
None
Eclampsia
Gestational Hypertension
HELLP
Preeclampsia
Preeclampsia requiring magnesium sulfate
Pre-existing Hypertension with superimposed preeclampsia
Unknown
Infection and Pregnancy D0017 Identification of infections affecting this pregnancy. Select all that apply.
None
Bacterial Infection
C-Difficile
Chlamydia
CMV (cytomegalovirus) infection
August 13, 2019 Page 83 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Infection and Pregnancy D0017 Identification of infections affecting this pregnancy. Select all that apply.
Enterovirus infections
Gonorrhea
Group B Streptococcus GBS infection is selected when there is an infection present in pregnancy and culture indicates GBS. The culture can come from blood, urine or swab.
Maternal Ancestry M0012 Mother's ethnic background to identify the patient as a member of a specific ethnic group to assess genetic risks.
East Asian
August 13, 2019 Page 84 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Maternal Ancestry M0012 Mother's ethnic background to identify the patient as a member of a specific ethnic group to assess genetic risks.
Asian Description: Indian, Pakistani, Bangladeshi
Black Description: African, Caribbean, African-American
Caucasian Description: European, Middle Eastern, North African, Hispanic
Other
Unknown
Maternal Antenatal HCP M0106 Designation of health care providers (HCP) that provided antenatal care.
None
Obstetrician
Family Physician
Midwife Registered midwife or traditionally trained Aboriginal midwife
Nurse
Nurse Practitioner (APN/CNS)
Other
Unknown
Maternal BMI M0019 Maternal pre-pregnancy Body Mass Index (BMI) defined as weight in kilograms divided by the square of the height in metres (kg/m2).
Maternal Canadian Postal Code at Conception
M0006 The postal code of mother's usual or permanent address closest to the time of conception.
Maternal Education Level M0011 Mothers highest level of education completed at time of birth.Create Father Education level field
Grade School Completed
High School not Completed
High School Completed
College/University not Completed
College/University Completed
August 13, 2019 Page 85 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Maternal Education Level M0011 Mothers highest level of education completed at time of birth.Create Father Education level field
Unknown
Maternal Family History NEW0012 Family health history of birth mother at time of data collection. If egg donor then document in Source of Gametes on Pregnancy tab.
None
Autism
Chromosome Abnormality
Chromosome Rearrangement
Congenital hearing loss
Congenital Heart Defect
Congenital visual impairment
Connective Tissue Disorders
Craniofacial Anomalies
Cystic Fibrosis
Developmental Delay (Mental Retardation)
Fragile X
Hemoglobinopathy
Hemophilia/bleeding Disorders
Learning Disabilities
Limb reduction defects
Metabolic Disorder
Neuromuscular Disorders
Skeletal Dysplasia
Spina Bifida/Neural Tube Defects
Tay Sachs
August 13, 2019 Page 86 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Maternal Family History NEW0012 Family health history of birth mother at time of data collection. If egg donor then document in Source of Gametes on Pregnancy tab.
Other
Unknown
Maternal Health Condition Other
M0013-2 Please specify maternal health condition and/or complications that could impact maternal, pregnancy or birth outcomes
Maternal Health Conditions
M0013 Select all maternal health conditions and/or complications including those pre-exisitng, diagnosed during pregnancy or active during pregnancy.
None Select None if not on available pick list.
Autoimmune \ Lupus
Autoimmune \ Other
Autoimmune \ Rheumatoid Arthritis
Cancer \ Diagnosed in Pregnancy
Cancer \ Prior to Pregnancy
Cardiovascular \ Acquired Heart Disease
Cardiovascular \ Antihypertensive Therapy outside of pregnancy
Cardiovascular \ Cardiovascular Disease
Cardiovascular \ Congenital Heart Defect
Cardiovascular \ Congenital Heart Disease
Cardiovascular \ Other
Cardiovascular \ Pre-existing Hypertension
Cardiovascular \ Renal Disease
Craniofacial \ Cleft Lip and/or palate
Craniofacial \ Craniosynostosis
Craniofacial \ Other
Diabetes \ Diabetes Type I
August 13, 2019 Page 87 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Maternal Health Conditions
M0013 Select all maternal health conditions and/or complications including those pre-exisitng, diagnosed during pregnancy or active during pregnancy.
Diabetes \ Diabetes Type II - No Insulin \ Diet management only
Diabetes \ Diabetes Type II - No Insulin \ Oral Anthyperglycemic Agents
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Maternal Health Conditions
M0013 Select all maternal health conditions and/or complications including those pre-exisitng, diagnosed during pregnancy or active during pregnancy.
Neurodevelopmental \ Hearing Disorder
Neurodevelopmental \ Learning Disabilities
Neurodevelopmental \ Vision Disorder
Neurodevelopmental \ Other
Neurology \ Cerebral palsy
Neurology \ Epilepsy/Seizures | Pre-existing Select if epilepsy and/or seizures were pre-exisiting prior to pregnancy.
Neurology \ Epilepsy/Seizures | Seizure occurred in current pregnancy
Select if onset of epilepsy and/or seizures was during pregnancy or if epilepsy/seizure were pre-exisiting and a seizure occurred during the pregnancy.
Neurology \ Multiple Sclerosis
Neurology \ Myasthenia Gravis
Neurology \ Spina Bifida/NTD
Neurology \ Other
Pulmonary \ Asthma | Pre-existing Select if asthma was pre-exisiting prior to pregnancy.
Pulmonary \ Asthma | Occurred in current pregnancy
Select if onset of asthma was during pregnancy or if asthma was pre-exisiting and an asthma attack or exacerbation occurred during the pregnancy.
Pulmonary \ Cystic Fibrosis
Pulmonary \ Previous Pulmonary Embolism/DVT
Pulmonary \ Pulmonary Hypertension
Pulmonary \ Other
Recurrent Spontaneous Abortion
Other, specify: This pick list value includes Health conditions that are not included in the specified available categories. For example, hip displasia, congenital abnormality.
Unknown
Musculoskeletal \ Other
August 13, 2019 Page 90 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Maternal Height (cm) M0017 Maternal height, measured in imperial or metric units. Reported in metric units.
Maternal Height Is Unknown
M0017UN
Maternal Height value entered by user through UI
M0017USERVAL
Maternal Marital Status M0010 Marital status of mother at time of collection (Maternal Serum Screen).
M0020-1 Self-reported amount of smoking per day at time of first prenatal visit
None
10-20 cigarettes/day
>20 cigarettes/day
Amount unknown
Unknown
Medication Exposure in Pregnancy
D0018 Indicate type of prescription and non-prescription (over-the-counter) medications taken during this pregnancy
None
Amphetamines
Antibiotics
Anticonvulsants
Anti-emetics
Antihistamines
Antinflammatory
Antiretrovirals
Antirheumatic
Antiviral
Cardiovascular
Chemotherapeutic Agents
Contraceptives
Gastrointestinal Agents
General anaesthetic
Herbal or homeopathic remedies
Insulin
August 13, 2019 Page 102 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Medication Exposure in Pregnancy
D0018 Indicate type of prescription and non-prescription (over-the-counter) medications taken during this pregnancy
Methadone/Subutex Prescription medications for the treatment of opioid addiction, they reduce cravings for the drug and suppress symptoms of opioid withdrawal.
Opioids Opioids are a type of drug used to relieve pain. Examples include: morphine, codeine, fentanyl, oxycodone, heroin, and hydromorphone. Opiates are naturally occurring narcotics whereas opioids include synthetic narcotics. (PCMCH Neonatal Abstinency Syndrome (NAS) Clinical Practice Guidelines, March 30, 2012).
Other over the counter medications
Other prescription
Psychotropic
Selective Seritonin Reuptake Inhibitors
Thyroid Medication
Vitamin A & Congeners
Vitamins
Other
Unknown
Mental Health Concerns M0048 Indicate any maternal mental health concerns during this pregnancy including those pre-existing, diagnosed during pregnancy or active during pregnancy. Both diagnosed or self reported.
None
Anxiety
Depression
History of Postpartum Depression
Addiction
Bipolar
Schizophrenia
Other
Unknown
August 13, 2019 Page 103 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Microarray genomic build / assembly
FAN1008-1 Indicates the human genome sequence assembly that was used to design and interpret the microarray data. In order to interpret any given microarray result (other than normal), the correct genome build/assembly must be used.
GRCh37/hg19
NCBI36/hg18
Unknown
Microarray results FAN1008-2 A comparison of patient DNA to ‘normal’ DNA (comparative genomic hybridization) used to assess gains and/or losses in DNA content.
Molecular Genetic Testing Details in Standard Nomenclature
FAN1005 The molecular results of the investigations, either selected from the pick list or entered in standard c.DNA nomenclature (for example, c.1274_1277dupTATC)
Molecular Genetic Testing Gene(s)
FAN1003 The gene on which molecular testing was performed Alpha globin
Aspartoacylase
Beta globin
CFTR
DMPK
Factor IX
Factor VIII
FANCC
FMR1
Hexosaminidase A
IKBKAP
MCOLN1
RecQ DNA helicase
SMPD1
Specify gene
August 13, 2019 Page 104 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Molecular Genetic Testing Gene(s) Other
FAN1010 The gene on which molecular testing was performed if the gene does not exist in the provided pick list
Molecular Genetic Testing Result General
FAN1004 Indicates whether an individual is affected with the disease, is a carrier of the disease or whether no mutations were identified
Affected
Affected (> 201 repeats), specify repeat size
Affected, specify mutations
Affected, specify repeat size (>49 repeats)
Carrier
Carrier, specify mutation
No mutations detected
Normal repeat size (>35 repeats) specify repeat size
Normal repeat size (5-44 repeats)
Premutation carrier (>44 repeats and >201 repeats) specify repeat size
Mother resides with smoker at first prenatal visit
M0020-2 At time of first prenatal visit, self-reported indication of whether woman resides with smoker
NT level MMMSS0017 Measurement of the nuchal translucency (NT), an echolucent area seen in longitudinal views of the back of the neck on ultrasound reported in millimeters. (Cunningham, 2005)
Number of Fetuses FAN0007 Number of fetuses in the current pregnancy. For Prenatal Screening Follow Up encounters, this field refers to the number of fetuses that the prenatal screening result was based on.
1
2
3
4
August 13, 2019 Page 105 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Number of Fetuses FAN0007 Number of fetuses in the current pregnancy. For Prenatal Screening Follow Up encounters, this field refers to the number of fetuses that the prenatal screening result was based on.
5
6
7
8
Unknown
Number of Living Children (L)
D0011 Number of living children at the time of pregnancy. Biological only, carried by mother, not necessarily cared for by mother and excludes adopted because this refers to mother's pregnancy history.
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
August 13, 2019 Page 106 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Number of Living Children (L)
D0011 Number of living children at the time of pregnancy. Biological only, carried by mother, not necessarily cared for by mother and excludes adopted because this refers to mother's pregnancy history.
Unknown
Number of Previous Abortions (A)
M0038 The total number of spontaneous or therapeutic abortions occurring prior to 20 completed weeks gestation. Spontaneous losses include ectopic pregnancy, missed abortion, blighted ova, and molar pregnancy.
0
1
2
3
4
5
6
10
11
12
13
14
15
16
17
18
19
20
Unknown
August 13, 2019 Page 107 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Number of Previous Cesarean Births
M0035 The total number of previous pregnancies resulting in a cesarean birth occurring at greater than or equal to 20 weeks and 0 days gestation. Number excludes current pregnancy. Multiple gestations are counted as one birth event.
0
1
2
3
4
5
≥6
Unknown
Number of Previous Preterm Pregnancies (P)
M0032 The total number of previous pregnancies delivered at less than 37 weeks and 0 days gestation. Multiple gestations are counted as one birth event.
0
1
2
3
4
5
6
7
8
9
10
Unknown
August 13, 2019 Page 108 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Number of Previous Stillbirths (S)
M0033 The total number of previous pregnancies resulting in a stillbirth. A stillbirth is defined as a product of conception weighing 500 grams or more or of 20 or more weeks gestation which, after being completely delivered, shows no sign of life. Intentional termination of pregnancy that meet either criterion are also classified as stillbirths in Ontario (1). Vital Statistics, Ontario Office of Registrar General (ORG), ServiceOntario.
0
1
2
3
4
5
6
Unknown
Number of Previous Term Pregnancies (T)
M0031 The total number of previous pregnancies delivered at greater than or equal to 37 weeks and 0 days gestation. Multiple gestations are counted as one birth event
0
1
2
3
4
5
6
7
8
9
10
11
August 13, 2019 Page 109 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Number of Previous Term Pregnancies (T)
M0031 The total number of previous pregnancies delivered at greater than or equal to 37 weeks and 0 days gestation. Multiple gestations are counted as one birth event
12
13
14
15
16
Unknown
Number of Previous Vaginal Births
M0034 The total number of prior pregnancies resulting in a vaginal birth occurring at greater than or equal to 20 completed weeks gestation. Number excludes current pregnancy. Multiple gestations are counted as one birth event.
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
August 13, 2019 Page 110 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Number of Previous Vaginal Births
M0034 The total number of prior pregnancies resulting in a vaginal birth occurring at greater than or equal to 20 completed weeks gestation. Number excludes current pregnancy. Multiple gestations are counted as one birth event.
16
Unknown
Number of previous VBACs
M0036 The total number of previous vaginal births after cesarean section (VBAC).
0
1
2
3
4
5
6
Unknown
Oncology Radiation Therapy Exposure In Pregnancy
D0015 Indicate whether this women underwent radiation therapy if there is a diagnosis of cancer prior to or during this pregnancy
Parity NEW1101 The number of previous births (term + preterm). This is automatically calculated.
Paternal Age P0001 Age of father at the time of data collection expressed in completed years.
Paternal Ancestry P0003 Father's ethnic background to identify the patient as a member of a specific racial or ethnic group to assess genetic risks.
East Asian
Asian Description: Indian, Pakistani, Bangladeshi
Black Description: African, Caribbean, African-American
Caucasian Description: European, Middle Eastern, North African, Hispanic
Other
Unknown
August 13, 2019 Page 111 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Paternal Family History NEW0013 Family health history of intended father at time of data collection. If sperm donor then document in Source of Gametes on Pregnancy tab.
None
Autism
Chromosome Abnormality
Chromosome Rearrangement
Congenital hearing loss
Congenital Heart Defect
Congenital visual impairment
Connective Tissue Disorders
Craniofacial Anomalies
Cystic Fibrosis
Developmental Delay (Mental Retardation)
Fragile X
Hemoglobinopathy
Hemophilia/bleeding Disorders
Learning Disabilities
Limb reduction defects
Metabolic Disorder
Neuromuscular Disorders
Skeletal Dysplasia
Spina Bifida/Neural Tube Defects
Tay Sachs
Other
Unknown
August 13, 2019 Page 112 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Paternal Health History P0004 Health history of father at time of data collection. None
Autism
Chromosome Abnormality
Chromosome Rearrangement
Congenital hearing loss
Congenital Heart Defect
Congenital visual impairment
Connective Tissue Disorders
Craniofacial Anomalies
Cystic Fibrosis
Developmental Delay (Mental Retardation)
Fragile X
Hemoglobinopathy
Hemophilia/bleeding Disorders
Learning Disabilities
Limb reduction defects
Metabolic Disorder
Neuromuscular Disorders
Skeletal Dysplasia
Spina Bifida/Neural Tube Defects
Tay Sachs
Other
Unknown
Paternal Occupation P0002 Paternal Occupation at time of data collection. Agriculture \ Natural Resources \ Agriculture \ Farm Worker
August 13, 2019 Page 113 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Paternal Occupation P0002 Paternal Occupation at time of data collection. Agriculture \ Natural Resources \ Environmental Field worker
Pregnancy Outcome F0053 Indicates the actual outcome of this pregnancy, including live births, stillbirths, terminations and losses. BORN encourages all hospitals to complete a Birth Mother encounter for all pregnancy losses that occur in your unit.
Stillbirth at >=20wks or >=500gms \ Termination
Stillbirth is defined as the complete expulsion or extraction from its mother of a product of conception either after the 20th week of pregnancy or after the product of conception has attained the weight of 500 grams or more, and where after such expulsion or extraction there is no breathing, beating of the heart, pulsation of the umbilical cord or movement of voluntary muscle (Vital Statistics Act, Ontario).
Pregnancy Loss <20 weeks and <500 gms \ Spontaneous Miscarriage
Select Pregnancy Loss <20 weeks only if weight is <500 gms.
Pregnancy Loss <20 weeks and <500 gms \ Termination
Select Pregnancy Loss <20 weeks only if weight is <500 gms.
Pregnancy Continued
Prenatal Diagnosis SubTest Name
PSDP004SUB The name of the specific test that was performed as selected from the defined pick list. See "Prenatal Diagnostic Procedures" tab for additional info
Prenatal Diagnosis Test Category
PSDP003 The category(-ies) of prenatal diagnostic testing offered. Unknown
August 13, 2019 Page 124 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Prenatal Diagnosis Test Failure Reason
PSDP007 The explanation as to why the prenatal diagnostic procedure and / or analysis failed, entered as free text.
Prenatal Diagnosis Test FISH Result
PSDP011 The specific results of the FISH prenatal diagnostic test Down syndrome
M0018 The mother's self-reported weight closest to conception and no later than 12 weeks of gestation (metric or imperial units).
Pre-pregnancy Maternal Weight Is Unknown
M0018UN
Pre-pregnancy Maternal Weight unit of measure used for data entry on the UI
M0018UOM
Pre-pregnancy Maternal Weight value entered by user through UI
M0018USERVAL Pre-pregnancy Maternal Weight value entered by user through UI
Primary Reason for Referral
FAN0023 Primary reason for the mothers' first referral to a tertiary centre for prenatal care during current pregnancy
History of Congenital Abnormality \ Maternal
History of Congenital Abnormality \ Paternal
History of Congenital Abnormality \ Sibling
History of Congenital Abnormality \ Previous Pregnancy
History of Congenital Abnormality \ Other
History of Congenital Abnormality \ Unknown
History of Inherited Condition \ Maternal
August 13, 2019 Page 134 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Primary Reason for Referral
FAN0023 Primary reason for the mothers' first referral to a tertiary centre for prenatal care during current pregnancy
History of Inherited Condition \ Paternal
History of Inherited Condition \ Sibling
History of Inherited Condition \ Other
History of Inherited Condition \ Unknown
Maternal Diseases
Maternal Exposure
Mother's Age > 35
Other
Positive Prenatal Screen
Ultrasound Abnormality
Unknown
No referral
Referral Date to FMU FAN0021 Date referral was received by the Fetal Medicine Unit in current pregnancy using standard date format.
Referral Date to FMU Is Unknown
FAN0021UN Indicates that the referral date to the Fetal Medicine Unit is unknown
Referral to FMU NEW0008 Indicates whether mother was referred to fetal medicine unit during current pregnancy.
Referral to Prenatal Genetics
NEW0007 Indicates whether mother was referred to prenatal genetics during current pregnancy.
Referred to FAN by FAN0024 Name and provider number of health care provider who initiates referral to Fetal Alert Network.
Family Physician
Medical Genetics
Medical Specialist
Midwife
Nursing practitioner
Obstetrician
August 13, 2019 Page 135 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Referred to FAN by FAN0024 Name and provider number of health care provider who initiates referral to Fetal Alert Network.
Perinatologist
Other
Unknown
Soft markers of ultrasound
PNFU0080-1 Variants of normal development detected by obstetrical ultrasound at specific periods during gestation which may increase the risk of a fetal anomaly and / or adverse obstetrical outcome
Anhydramnios
Brachycephaly
Choroid plexus cysts
Clinodactyly
Cystic hygroma
Ductus venosus blood flow
Echogenic yolk sac
Enlarged cisterna magna
Frontomaxillary facial angle
Hydronephrosis
Hyperechogenic bowel
Iliac angle
Intracardiac echogenic focus / focii
Intrauterine growth retardation
Nasal bone, absent
Nasal bone, hypoplastic
Nuchal fold / edema, increased
Nuchal translucency, increased
Oligohydramnios
Pericardial effusion
August 13, 2019 Page 136 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Soft markers of ultrasound
PNFU0080-1 Variants of normal development detected by obstetrical ultrasound at specific periods during gestation which may increase the risk of a fetal anomaly and / or adverse obstetrical outcome
Placental thickness
Pleural effusion
Polyhydramnios
Renal pelves
Pyelectasis
Sandal gap
Short femur
Short humerus
Small ear length
Tricuspid valve regurgitation
Two vessel cord / single umbilical artery
Umbilical cord cyst
Uterine artery notching
Ventriculomegaly
Soft markers of ultrasound (level 2)
PNFU0080-2 The detailed description of the soft marker or obstetrical ultrasound finding where available
Mild
Moderate
Severe
Septated
Not septated
Normal
Abnormal (reversed)
Not otherwise specified
Biventricular
August 13, 2019 Page 137 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Soft markers of ultrasound (level 2)
PNFU0080-2 The detailed description of the soft marker or obstetrical ultrasound finding where available
L ventricle
R ventricle
L atrium
R atrium
Single
Multiple
Grade I (less bright than bone)
Grade II (as bright as bone)
Grade III (brighter than bone)
Right
Left
Bilateral
Unilateral
Right artery absent
Left artery absent
Symmetrical
Asymmetrical
N/a
Unknown
Soft markers of ultrasound Measurement Name
PNFU0080-3 Name of the soft marker or obstetrical imaging finding Right Dimension (mm)
Left Dimension (mm)
Measurement (mm)
Right Measurement (mm)
August 13, 2019 Page 138 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Soft markers of ultrasound Measurement Name
PNFU0080-3 Name of the soft marker or obstetrical imaging finding Left Measurement (mm)
HC Percentile
BPD Percentile
AC Percentile
FL Percentile
AFI (amniotic fluid index)
Right Percentile
Left Percentile
Degree of Angle
NT MoM
Delta NT
Soft markers of ultrasound Measurement Value
PNFU0080-4 Measurement of the soft marker or obstetrical imaging finding
Source of Gametes NEW0004 Source of sperm and egg for this pregnancy; reflects biological parents as documented or source(s) if reproductive assistance was required.
Donor egg
Donor Sperm
Donor sperm and egg
Parents as documented
Unknown
Subspecialty Consults FAN0012 Any sub-specialty consults undertaken during the course of prenatal care.
Anesthesia
Cardiology
Chaplaincy
Clinical Nurse Specialist/Advanced Practice Nurse (CNS/APN)
August 13, 2019 Page 139 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Subspecialty Consults FAN0012 Any sub-specialty consults undertaken during the course of prenatal care.
Endocrine
General Surgery
Genetic Counsellor
Geneticist
MFM second opinion
Neonatology
Nephrology
Neurology
Neurosurgery
None
Orthopaedics
Other
Palliative care
Plastic Surgery
Psychiatry
Psychology
Rehab Centre
Social Work
Urology
Unknown
Time between Referral and first visit to FMU in days
FAN105 Calculated. Measured in days
August 13, 2019 Page 140 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Time between Referral and first visit to PNU/Genetics in days
FAN104 A calculated Time between Referral and first visit to PNU/Genetics in days
Time prenatal PRBC transfusion
D0073 The time that the prenatal (in utero) PRBC transfusion was performed (if there were multiple performed, enter the most recent)
Type of Conception M0201 Method of conception for this pregnancy; indicates if reproductive assistance was required to achieve current pregnancy
Spontaneous Assisted reproductive technology was not used
Intrauterine insemination alone Sperm is instilled directly into the uterine cavity through a syringe and catheter. Can be partner or donor sperm. Referred to as IUI.
Intrauterine insemination with ovulation induction but no IVF
Same as intrauterine insemination (IUI) but woman received drugs to stimulate ovulation prior to the IUI. The woman may produce one or many eggs as the result of the stimulation protocol. Multiple births are a risk with this procedure. Sometimes, an ultrasound is performed prior to the IUI to determine how many follicles have matured and the procedure may not be carried out if many eggs are produced.
Ovulation Induction without IVF ( ie clomid or FSH)
Drugs are given to stimulate ovulation. Normal intercourse, IUI (intrauterine insemination) or vaginal insemination follows but no other manipulation of the egg or sperm.
IVF In Vitro fertilization - Eggs are retrieved from the ovaries through a transvaginal (usually) procedure, guided by ultrasound that shows where the mature follicles are. Eggs are then placed in a sperm solution and fertilization occurs. Fertilized embryos are grown in the lab for a few days (3 or 5) and then a certain number are transferred back into the uterus. The remainder of viable embryos may be frozen for future use.
IVF ICSI In Vitro Fertilization with Intra Cellular Sperm Injection - A single sperm is chosen from the sperm sample and injected directly into the egg for fertilization. The embryo(s) fertilized are then transferred into the uterus as in a regular IVF procedure and/or frozen for future use.
Surrogate A Gestational Carrier. Another women carries the embryo/fetus for the couple who are unable to carry a pregnancy for whatever reason. The baby is surrendered at birth to the fertility patient.
Vaginal insemination
Unknown
August 13, 2019 Page 141 of 142
Encounter: Antenatal SpecialtyData Element Name BORN ID Data Element Definition Pick List Value Pick List Definition
Woman Abuse D0019 The self-disclosed threat of or actual physical, sexual, psychological, emotional or financial abuse.
No disclosure Asked but no abuse disclosed or asked and responded 'No'
Disclosure
Unable to ask Not asked, for any reason. Not documented in the chart.
Zygosity M0200 The nature of the zygotes from which individuals are derived; e.g., whether by separation of the division of one zygote (monozygotic) , in which case they will be genetically identical, or from two separate fertilized ova (dizygotic).