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Cathy Richardson

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A request has been received regarding the terming of the concept 169826009 |Single live birth (finding)| as it could be interpreted to mean a single live birth from a singleton pregnancy or alternatively a single live birth from a multiple pregnancy. The requester suggested it be re-termed to make it clear it was from a singleton pregnancy.
This concept has high usage when looking at UK usage data.
The concept looks to be derived from ICD 10. In ICD Z37 Outcome of delivery has the exact wording: Z37.0 Single live birth. The category then goes on to have separate ICD-10 codes for other birth outcomes.
The meaning of this concept needs to be clarified. This could be undertaken through inactivation and replacement (but it is a high usage concept) or alternatively, description changes.
Possible new concepts would be:
Live birth from singleton pregnancy
Live birth from multiple pregnancy.

Input from the CMAG is being sought on:
- the meaning of that concept in your country
- usage in your country
- the preferred solution for your country

Please provide your responses by the end of July. If additional time is needed please let us know.

Response due date extended until 6th September. 

Thank you.

Contributors (5)

6 Comments

  1. John Snyder

    Hi Cathy,

    I have requested feedback from several clinical subject matter experts and to-date have received only one response as follows:

    Source 1:

    As a physician, “single live birth” would not be confused with multiple pregnancies. If I just saw or heard “single live birth” alone I would not think about multiple pregnancies. Can you not just keep the “Single live birth” description and add “Single live birth from singleton pregnancy” as the FSN?

    Source 2:  

    1. We do not have usage statistics for this concept
    2. We support the proposal to inactivate the existing concept and create the two new concepts.  However, we noted that the proposed FSNs for the new concepts do not capture the “single-ness” of the original concept 169826009 |Single live birth (finding).  In other words, for clarity, it may be desirable to add “Single” to the FSNs of the new concepts.

    Source 3:

    The following value sets from the Value Set Authority Center (VSAC) contain the concept, 169826009 |Single live birth (finding)| , with the following metadata:

    • Value Set Name: Delivery of Singleton
    • Steward: The Joint Commission
    • Definition Version: 20210611
    • OID: 2.16.840.1.113762.1.4.1045.173
    • FHIR URI: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.173
    • Clinical Focus: The purpose of this value set is to group diagnoses of a fetus in an abnormal position in the uterus at the time of delivery.



    • Value Set Name: Complications of Pregnancy, Childbirth and the Puerperium
    • Steward: National Committee for Quality Assurance
    • Definition Version: 20230209
    • OID: 2.16.840.1.113883.3.464.1003.111.11.1023
    • FHIR URI: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.111.11.1023
    • Clinical Focus: The purpose of this value set is to represent concepts for a diagnosis of complications related to pregnancy or childbirth.


    I will append any additional comments I receive before the deadline to this post.

    1. Cathy Richardson

      Thanks for your input John. 

  2. Elze de Groot

    We can't find any usage of this concept. The concept is translated in Dutch as 'Single live birth from singleton pregnancy', so that is our interpretation of the concept. Depending on how the concept is changed, it could have impact on our translation and meaning of the concept. Changing the concept as source 1 of John proposed would have no impact for us (keep the “Single live birth” description and add “Single live birth from singleton pregnancy” as the FSN). The most clean way would be to deactivate the concept and create 2 replacements.

  3. Katrien Scheerlinck

    Hi all,


    In Belgium we refer in our translations (French & Dutch) of this concept to a single pregnancy. So no confusion from our site with multiple pregnancies or ambiguity of the concopt/fsn. I agree with John his suggestion about keeping the FSN and adding a synonym.


    fyi, we included this concept in our GP reference sets (721000172106)



  4. Janice Spence

    Hello Everyone,

    The Canadian NRC has received feedback from one clinician consultant who supports the addition of additional descriptions for clarity:

    I can understand how this term could require clarification:

     concept 169826009 |Single live birth (finding)|

     I am supportive of the proposed description changes with the clarification options below:

     Live birth from singleton pregnancy
    Live birth from multiple pregnancy

     Both of the above concepts are in common usage in Canada, and should be understood by clinicians (physicians and nurses in particular). The clarification above is quite straightforward and makes good sense.

     Thanks

  5. Cathy Richardson

    Hi all,

    Please be advised the following changes have been made for the December 2024 release.

    • 169826009|Single live birth (finding)| has been updated to 169826009 |Single live birth from singleton pregnancy (finding)|. A synonym Singleton live birth has been retained.
    • A new concept 1351929005 |Single live birth from multiple pregnancy (finding)| has been added. 

    Kind regards,

    Cathy Richardson