Dear all, on the 10th August I see there has been a meeting and I am particulary interested in the outcome of point 3 of the agenda: Fetal/maternal modeling. For a Dutch reference set for gynaecology we are asked to create several new Snomed concepts which are all of the same sort <fetal disorder> during <pregnancy>, for example 'Fetal anencephaly in pregnancy' and 'Hydrops fetalis in pregnancy' etc. These disorders would be registered for the expectant mother. For the fetus there are concepts (609417004 |Fetal anencephaly (disorder)| and 276508000 |Hydrops fetalis (disorder)|) The thing we are struggling with is under which parents to put these new concepts. Should the parent for 'fetal anencephaly in pregnancy' have the parent 609417004 |Fetal anencephaly (disorder)|?

Besides the question whether the <fetal disorder in the pregnancy> should have the concept for the <fetal disorder> as a parent, we are also unsure what other parent we should give it. Should 128604004 |Disorder of product of conception (disorder)| be a parent? or 11082009 |Abnormal pregnancy (finding)|? 

Is this subject currently being looked at in this group or does anybody have a straightforward answer or would it be a possibility to put this on the agenda for a next meeting? 

Thanks so much in advance!

Best wishes,

Natasha

Natasha Krul (Unlicensed) ,  in the use case you are discussing, you are adding context to the fetal disorder in order to assign the subject of record to "Fetus of subject", which is a notion that we do not have in SNOMED CT currently.  With regards to modeling, these types of concepts would need to be modeled as Situations with explicit context. So a concept such as 'Fetal anencephaly in pregnancy' would be modeled as:

IS A 243796009 |Situation with explicit context (situation)|:

            (246090004 |Associated finding (attribute)| = 609417004 |Fetal anencephaly (disorder)|,

             408731000 |Temporal context (attribute)| = 15240007 |Current (qualifier value)|

             408732007 |Subject relationship context (attribute)| = Fetus of subject (new concept)

             408729009 |Finding context (attribute)| = 410515003 |Known present (qualifier value)|)

This would be sufficiently defined so the classifier would place it appropriately, unless there were intermediate primitives, which would be detected if the classification was not as expected.  This type of term does not belong in the clinical findings hierarchy due to the explicit context needed.

Jim Case  thank you very much for your quick response! Makes perfect sense! According to my colleague there are also a few concepts describing <fetal disorder>  during <labor>. Would you recommend using the same definition as you described above? Im not sure if we can make a disctinction between <during pregnancy>  and <during labor>?