Fundal Height how is this data captured ? Archetype?

So we’ve also been working on the Antenatal Encounter.
In discussions with Ian we were pointed to the Palpation of Uterus cluster archetype and we wondered if there has been any additional work that would superceded this, or thoughts about capturing fundal height as a standalone data point?

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@heatherleslie @danielle.santosalves - what is the state of the art here?

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Hi Ian,

I’m using the ‘openEHR-EHR-CLUSTER.exam-palpation-uterus.v0’ [https://ckm.openehr.org/ckm/archetypes/1013.1.3996] - Fundal measurement inside the OBSERVATION - Physical examination findings [https://ckm.openehr.org/ckm/archetypes/1013.1.271] .

I hope it could help you!

Hi Keisha,

I’m also working on the Perinatal care modelling process for my PhD. If you want to share some thoughts with me, feel free to contact me! :wink:

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is there utility to having this as more structured data?
is it normal to actually track or graph fundal height to determine if the pregnancy is appropriate for gestational age ? SGA LGA ? etc

Totally agree @danielle.santosalves.

@KBarwise @ct.delisser Measuring fundal height is a part of physical exam, just like checking swollen ankles. The archetype allows multiple ways to measure the fundal height - measurement in cm, size estimation in gestation weeks and size estimation in relation to anatomical landmarks. Common antenatal forms don’t represent it like this, but it works as far as data structure - we don’t want to duplicate this, this is what templates are for.

Regards

Heather

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The measurement is intended just to capture the measurement during a physical exam. Interpretation of the measurement is an additional layer of abstraction, although our common modelling pattern does include the simple and generic ‘Clinical interpretation’, where you could include SGA, LGA as values in a template or normal/abnormal etc. Or if it is significant enough, a specific ?EVAL archetype could be developed for purpose.
I’m interested to understand more about what additional structure you might require. Then we need to consider the best way to model it.

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@KBarwise, it’s also possible to have a graph (fundal height x gestational age). You can either model a template only for that or use your data from the database and some other template. You have to have a tool to build your graph interface.
But I agree with @heatherleslie that maybe we need more information from your side. :wink:

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I COMPLETELY messed up, I might have been looking at something else entirely and now see where all of this is adequately captured and appropriate for the existing archetype.

If we do attempt graphs it will be using EHR Studio.

Thank you both for your help, and apologies for the misunderstanding.

I will however take you up on your offer @danielle.santosalves and reach out and share the work we are doing.

Thank you again

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Perfect Keisha!

No problem! As @vanessap says: There are no silly questions! Here is the space to change experiences.

We are here for any help that you need!

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