ARCHETYPE Fetal Heart Monitoring (openEHR-EHR-OBSERVATION.fetal_heart-monitoring.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.fetal_heart-monitoring.v1
ConceptFetal Heart Monitoring
DescriptionMonitoring of the characteristics of the fetal heart rate , usually over intervals of time.
UseUse to record the details about the fetal heart beat during periods of monitoring, usually in late pregnancy or during labor. Use to capture findings from electronic monitoring, including cardiotocography. Use is restricted to recording details about the heart beat of a fetus.
MisuseNot to be used to record simple, intermittent measurements of fetal heart rate - use the parent archetype OBSERVATION.fetal_heart instead. Not to be used for recording the heart rate of infants, children or adults.
PurposeTo record details about the fetal heart beat during periods of fetal monitoring to assist in the assessment of fetal well-being.
ReferencesSOGC Fetal health Surveillance: antepartum and intrapartum Consensus Guideline: http://www.sogc.org/guidelines/documents/gui197CPG0709r.pdf

Intrapartum care: management and delivery of care to women in labour: http://www.nice.org.uk/nicemedia/live/11837/36275/36275.pdf
Copyright© openEHR Foundation
AuthorsAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2011-01-21
Other Details LanguageAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2011-01-21
OtherDetails Language Independent{references=SOGC Fetal health Surveillance: antepartum and intrapartum Consensus Guideline: http://www.sogc.org/guidelines/documents/gui197CPG0709r.pdf Intrapartum care: management and delivery of care to women in labour: http://www.nice.org.uk/nicemedia/live/11837/36275/36275.pdf, MD5-CAM-1.0.1=26FBAED81D6AB4D33617DCF91AD51BC7}
Keywordsfetal, heart, beat, rate, rhythm
LifecycleCommitteeDraft
Language useden
Citeable Identifier1013.1.1198
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Monitoring of the characteristics of the fetal heart rate , usually over intervals of time., archetypeConceptComment=null, otherContributors=Sam Heard, originalLanguage=en, translators=, subjectOfData=Foetus, archetypeTranslationTree=null, topLevelToAshis={details=[], identities=[], source=[], credentials=[], context=[], description=[], ism_transition=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1], code=at0002.1, itemType=INTERVAL_EVENT, level=2, text=Any Monitoring Interval, description=Any unspecified period of monitoring., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=INTERVAL_EVENT, bindings=null, values=Math. function: Actual
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0.27], code=at0.27, itemType=INTERVAL_EVENT, level=2, text=Baseline Monitoring, description=Monitoring interval used as the basis for later comparisons eg not in labor or in early labor., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=INTERVAL_EVENT, bindings=null, values=Math. function: Actual
, extendedValues=null]], content=[], items=[], capabilities=[], other_participations=[], contacts=[], target=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Heart beat present?, description=The fetal heart beat is detected., comment=Implied as true if fetal heart rate > 0., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0005.1], code=at0005.1, itemType=ELEMENT, level=4, text=Heart Rate, description=The measured rate of the fetal heart during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Quantity
    Property: Frequency
    Units:
    • /min
  •  Interval of Quantity

    Lower: Property: Frequency
    Units:
    • >=0.0 /min
      Limit decimal places: 0

    Upper: Property: Frequency
    Units:
    • >=0.0 /min
      Limit decimal places: 0

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.2], code=at0.2, itemType=ELEMENT, level=4, text=Variability, description=Variability in the fetal heart rate observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_INTERVAL, bindings=null, values=Lower: Property: Frequency
Units:
  • /min

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.3], code=at0.3, itemType=ELEMENT, level=4, text=Variability Category, description=Category of variability observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Absent [Heart rate variability is undetectable.]
  • Minimal [Heart rate variability is greater than undetectable, but less than or equal to 5 beats per minute.]
  • Moderate [Heart rate variability is between 6-25 beats per minute.]
  • Marked [Heart rate variability is greater than 25 beats per minute.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.8], code=at0.8, itemType=ELEMENT, level=4, text=Variability Pattern, description=Description of the pattern of variability observed during the monitoring interval., comment=For example, identifying a sinusoidal pattern., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.9], code=at0.9, itemType=ELEMENT, level=4, text=Accelerations, description=Presence of accelerations observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Absent [Heart rate accelerations are undetectable.]
  • Present [Heart rate accelerations are present and occurring spontaneously.]
  • Present with fetal scalp stimulation [Fetal heart accelerations are detected as a result of fetal scap stimulation.]
  • Absent with fetal scalp stimulation [Fetal heart rate accelerations are not detected with fetal scalp stimulation.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.14], code=at0.14, itemType=ELEMENT, level=4, text=Early Decelerations, description=Frequency of early accelerations observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • None [No decelerations detected.]
  • Occasional [Occasional decelerations detected but occur in association with less than 50% of uterine contractions..]
  • Repetitive [Decelerations detected in association with over 50% of uterine contractions.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.18], code=at0.18, itemType=ELEMENT, level=4, text=Uncomplicated Variable Decelerations, description=Frequency of uncomplicated variable decelerations observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • None [No decelerations detected.]
  • Occasional [Occasional decelerations detected but occur in association with less than 50% of uterine contractions..]
  • Repetitive [Decelerations detected in association with over 50% of uterine contractions.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.19], code=at0.19, itemType=ELEMENT, level=4, text=Complicated Variable Decelerations, description=Frequency of complicated variable decelerations observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • None [No decelerations detected.]
  • Occasional [Occasional decelerations detected but occur in association with less than 50% of uterine contractions..]
  • Repetitive [Decelerations detected in association with over 50% of uterine contractions.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.20], code=at0.20, itemType=ELEMENT, level=4, text=Late Decelerations, description=Frequency of late decelerations observed during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • None [No decelerations detected.]
  • Occasional [Occasional decelerations detected but occur in association with less than 50% of uterine contractions..]
  • Repetitive [Decelerations detected in association with over 50% of uterine contractions.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.21], code=at0.21, itemType=ELEMENT, level=4, text=Prolonged Deceleration, description=Duration of a single, prolonged deceleration observed during the monitoring interval., comment=Can be recorded multiple times during the period of observation - one duration recorded for each discrete deceleration., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=Allowed values: minutes, seconds
>=0 seconds
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.22], code=at0.22, itemType=ELEMENT, level=4, text=Multimedia Representation, description=Inclusion of any multimedia file to support the recording of findings during fetal heart monitoring., comment=For example, printed recording of the CTG., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0009.1], code=at0009.1, itemType=ELEMENT, level=4, text=Comment, description=Additional narrative about the fetal heart monitoring not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0.23], code=at0.23, itemType=ELEMENT, level=4, text=Tracing Assessment, description=Overall conclusion regarding findings during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Normal [Monitoring during this interval reveals a normal Fetal Heart Rate pattern.]
  • Atypical/Suspicious [Monitoring during this interval reveals an atypical or suspicious pattern.]
  • Abnormal/Pathological [Monitoring during this interval reveals an abnormal or pathological pattern.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/data[at0003]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Conclusion, description=Concise and clinically contextualised narrative interpretation of the fetal heart rate., comment=For example, bradycardia or tachycardia., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], relationships=[], state=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/state[at0011]/items[at0012.1], code=at0012.1, itemType=ELEMENT, level=4, text=Position of Mother, description=The position of the mother during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Standing [Mother standing at the time of fetal heart rate measurement.]
  • Sitting [Mother sitting at the time of fetail heart rate measurement.]
  • Reclining [Mother reclining at the time of fetal heart rate measurement.]
  • Lying [Lying flat at the time of fetal heart rate measurement.]
  • Lying with tilt to left [Mother lying flat with some lateral tilt towards the left.]

Assumed value: Lying with tilt to left, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/state[at0011]/items[at0019.1], code=at0019.1, itemType=ELEMENT, level=4, text=Maternal Confounding Factors, description=Description of incidental maternal factors, not recorded elsewhere, that may cause difficulties in monitoring or effect the quality of the tracing., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/state[at0011]/items[at0.28], code=at0.28, itemType=ELEMENT, level=4, text=Fetal Confounding Factors, description=Description of incidental maternal factors, not recorded elsewhere, that may cause difficulties in monitoring or effect the quality of the tracing., comment=For example, posterior position or active fetal movement., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/state[at0011]/items[at0.29], code=at0.29, itemType=ELEMENT, level=4, text=In Labor?, description=Was the mother in active labor during the monitoring interval?, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Not in labor [Mother is not in labor.]
  • In labor [Mother is in active labor.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002.1]/state[at0011]/items[at0.32], code=at0.32, itemType=ELEMENT, level=4, text=Labor Description, description=Description of labor during the monitoring interval., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0018]/items[at0020], code=at0020, itemType=SLOT, level=2, text=Device, description=Details about the device used to auscultate the fetal heart rate. For example, details about the CTG machine., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.device.v1 and specialisations, extendedValues=null]], activities=[], provider=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002.1]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], state=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002.1]/state[at0011], code=at0011, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0018], code=at0018, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0018]/items[at0020], code=at0020, itemType=SLOT, level=2, text=Device, description=Details about the device used to auscultate the fetal heart rate. For example, details about the CTG machine., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
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