Fetal Growth Assessment

Hello! We’re working on a Fetal Growth Assessment archetype and we’re modelling it based on the Child Growth Indicators archetype.
Could you take a look at this and let us know what you think?

Hi Candice,

Apologies for the delay.
I’ve spent some time today trying to understand what you are trying to do, and I think I’ve teased it out.

If we’re trying to record aspects of fetal growth via growth charts makes great sense to mimic the Child growth archetype - totally agree.

I found a WHO document that describes some of the fetal growth charts - https://www.ajog.org/article/S0002-9378(17)32485-7/fulltext#secsectitle0040. There may be more, if we spent more time looking. I didn’t realise they existed, so this provides the foundation for modelling as per the Child growth pattern.

Also a PAHO document - https://www.paho.org/clap/index.php?option=com_docman&view=download&alias=241-monitoring-fetal-growth-self-instruction-manual-2nd&category_slug=salud-de-mujer-reproductiva-materna-y-perinatal&Itemid=219&lang=es

I’ve mind mapped my thinking (of course) - 2021 03 04 Growth indicators.xmind (286.2 KB) . We need a Fetal Growth OBS, effectively a copy of the child growth(rather than a specialisation, due to different subjects of care and different value sets), just as you’d proposed.

In order to support these various ‘measurement-for-gestational-age’ charts, we need to record the raw data. This will need to be recorded as a CLUSTER within the Imaging OBS. I’ve been doing some work on this, so could prioritise the pregnancy US cluster, if that is useful to you.

Also some other OBSERVATIONs as per the PAHO and WHO references - Abdo circumference/femur length ration; Femur length/biparietal diameter ratio; and femur length/head circumference ratio. These seem to be tracked over time to ensure the ration stays around the same value.

Does this align with your thinking?

H