A C113099 Pediatric Failure to Thrive Less than normal weight gain in an infant or child, which may include poor linear and head growth. Failure to Thrive C125481 GAIA Terminology A C113492 Dysfunctional Labor Uterine contractions (less than 3 in 10 minutes or inadequate strength) that do not result in progressive cervical dilation. Dysfunctional Labor Prolongation in the duration of labor, typically during the first stage of labor. Diagnosis of a delay in labor is dependent upon careful monitoring of uterine contraction intensity, duration, and frequency, cervical dilation, and the descent of the fetus through the pelvis. C125481 GAIA Terminology A C114371 Antepartum Hemorrhage Excessive blood loss prior to onset of labor. Antenatal Bleeding A clinical syndrome that is characterized by bleeding during the second or third trimester of pregnancy. Pathologic etiologies attributable to the pregnant state include placenta previa, morbidly adherent placenta, vasa previa, placental abruption, cesarean scar pregnancy, intra-abdominal pregnancy, and uterine rupture. C125481 GAIA Terminology A C114875 Fetus Small for Gestational Age A fetus that does not grow beyond the 10th percentile of conventionally accepted weight for gestational age. Fetal Growth Restriction A fetus with a sonographic estimation of fetal weight below the tenth percentile for a given gestational age, with increasing specificity for adverse perinatal outcomes below the third percentile. C125481 GAIA Terminology A C114935 Very Low Birth Weight Birth weight less than 1500 grams. Very Low Birth Weight C125481 GAIA Terminology A C114936 Extremely Low Birth Weight Birth weight less than 1000 grams. Extremely Low Birth Weight C125481 GAIA Terminology A C128710 GAIA Level 1 Ectopic Pregnancy GAIA Level 1 Ectopic Pregnancy is defined by two criteria: first, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) Transvaginal Ultrasound showing extrauterine pregnancy; OR c) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; second, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 1 Ectopic Pregnancy Level 1 Ectopic Pregnancy is defined by two criteria: first, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) Transvaginal Ultrasound showing extrauterine pregnancy; OR c) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; second, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C125481 GAIA Terminology A C128711 GAIA Level 2 Ectopic Pregnancy GAIA Level 2 Ectopic Pregnancy is defined by three criteria: first, it does not qualify as a Level 1 Ectopic Pregnancy; second, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; third, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 2 Ectopic Pregnancy Level 2 Ectopic Pregnancy is defined by three criteria: first, it does not qualify as a Level 1 Ectopic Pregnancy; second, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; third, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C125481 GAIA Terminology A C128712 GAIA Level 3 Ectopic Pregnancy GAIA Level 3 Ectopic Pregnancy is defined by four criteria: first, it does not qualify as either a Level 1 or a Level 2 Ectopic Pregnancy; second, a positive urine pregnancy test; third, no products of conception are found on endometrial curettage after a dilation and curettage procedure; fourth, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 2 or 3). Level 3 Ectopic Pregnancy Level 3 Ectopic Pregnancy is defined by four criteria: first, it does not qualify as either a Level 1 or a Level 2 Ectopic Pregnancy; second, a positive urine pregnancy test; third, no products of conception are found on endometrial curettage after a dilation and curettage procedure; fourth, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 2 or 3). C125481 GAIA Terminology A C128713 GAIA Level 4 Ectopic Pregnancy GAIA Level 4 Ectopic Pregnancy is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 Ectopic Pregnancy; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. Level 4 Ectopic Pregnancy Level 4 Ectopic Pregnancy is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 Ectopic Pregnancy; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. C125481 GAIA Terminology A C128714 Morbidly Adherent Placenta A condition in which the placenta implants abnormally into the uterine myometrium, rather than implanting into the uterine decidua basalis as is normal. Morbidly Adherent Placentation A condition in which the placenta implants abnormally into the uterine myometrium, rather than implanting into the uterine decidua basalis as is normal. C125481 GAIA Terminology A C128715 Cesarean Scar Pregnancy An ectopic pregnancy implanted in a previous cesarean (hysterotomy) scar, surrounded by myometrium and connective tissue. Cesarean Scar Pregnancy An ectopic pregnancy implanted in a previous cesarean (hysterotomy) scar, surrounded by myometrium and connective tissue. C125481 GAIA Terminology A C128716 Uterine Rupture The complete, nonsurgical disruption of all layers of the uterus. Uterine Rupture The complete, nonsurgical disruption of all layers of the uterus. C125481 GAIA Terminology A C128717 GAIA Level 1 Dysfunctional First Stage of Labor GAIA Level 1 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) and with confirmed ruptured membranes. Level 1 Dysfunctional First Stage of Labor Level 1 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) and with confirmed ruptured membranes. C125481 GAIA Terminology A C128718 GAIA Level 2 Dysfunctional First Stage of Labor GAIA Level 2 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) without certainty of ruptured membranes. Level 2 Dysfunctional First Stage of Labor Level 2 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) without certainty of ruptured membranes. C125481 GAIA Terminology A C128719 GAIA Level 1 Dysfunctional Second Stage of Labor GAIA Level 1 Dysfunctional Second Stage of Labor is defined by three criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus); second, the onset of the active stage of labor (active maternal effort (i.e. pushing) or visible baby); third, at least one of the following requirements must be met: a) Greater than 2 hours of pushing (in nulliparous women); OR b) Greater than 1 hour of pushing (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. Level 1 Dysfunctional Second Stage of Labor Level 1 Dysfunctional Second Stage of Labor is defined by three criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus); second, the onset of the active stage of labor (active maternal effort (i.e. pushing) or visible baby); third, at least one of the following requirements must be met: a) Greater than 2 hours of pushing (in nulliparous women); OR b) Greater than 1 hour of pushing (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. C125481 GAIA Terminology A C128720 GAIA Level 2 Dysfunctional Second Stage of Labor GAIA Level 2 Dysfunctional Second Stage of Labor is defined by two criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus) during any phase of the second stage of labor; second, at least one of the following requirements must be met: a) No delivery within 3 hours of full dilation (in nulliparous women); OR b) No delivery with 2 hours of full dilation (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. Level 2 Dysfunctional Second Stage of Labor Level 2 Dysfunctional Second Stage of Labor is defined by two criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus) during any phase of the second stage of labor; second, at least one of the following requirements must be met: a) No delivery within 3 hours of full dilation (in nulliparous women); OR b) No delivery with 2 hours of full dilation (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. C125481 GAIA Terminology A C128721 GAIA Level 1a Fetal Growth Restriction GAIA Level 1a Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Level 1a Fetal Growth Restriction Level 1a Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. C125481 GAIA Terminology A C128722 GAIA Level 1b Fetal Growth Restriction GAIA Level 1b Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Level 1b Fetal Growth Restriction Level 1b Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. C125481 GAIA Terminology A C128723 GAIA Level 2a Fetal Growth Restriction GAIA Level 2a Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Level 2a Fetal Growth Restriction Level 2a Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. C125481 GAIA Terminology A C128724 GAIA Level 2b Fetal Growth Restriction GAIA Level 2b Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Alternatively, Level 2b may be defined by the following two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve, and absence of oligohydramnios as defined by amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2, and the inability to assess umbilical artery Doppler. Level 2b Fetal Growth Restriction Level 2b Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Alternatively, Level 2b may be defined by the following two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve, and absence of oligohydramnios as defined by amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2, and the inability to assess umbilical artery Doppler. C125481 GAIA Terminology A C128725 GAIA Level 1 Low Birth Weight GAIA Level 1 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; an electronic scale that is graduated to 10 grams is used; the scale is calibrated at least once a year; the scale is placed on level, hard surface; the scale is tared to zero grams; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 5 of diagnostic level of certainty one. Level 1 Low Birth Weight Level 1 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; an electronic scale that is graduated to 10 grams is used; the scale is calibrated at least once a year; the scale is placed on level, hard surface; the scale is tared to zero grams; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 5 of diagnostic level of certainty one. C125481 GAIA Terminology A C128726 GAIA Level 2 Low Birth Weight GAIA Level 2 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; either an electronic or a spring scale that is graduated to 50 grams is used; the scale is calibrated at least once a year, or more often if moved; the scale is tared to zero grams or 0.00 kg; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 4 of diagnostic level of certainty two. Level 2 Low Birth Weight Level 2 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; either an electronic or a spring scale that is graduated to 50 grams is used; the scale is calibrated at least once a year, or more often if moved; the scale is tared to zero grams or 0.00 kg; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 4 of diagnostic level of certainty two. C125481 GAIA Terminology A C128727 GAIA Level 3 Low Birth Weight GAIA Level 3 Low Birth Weight is defined by three criteria: first, a newborn infant must be weighed within the first 48 hours of life; second, weight is measured using a dial/ spring/ color-coded scale; third, weight is assessed as less than 2500 grams. Level 3 Low Birth Weight Level 3 Low Birth Weight is defined by three criteria: first, a newborn infant must be weighed within the first 48 hours of life; second, weight is measured using a dial/ spring/ color-coded scale; third, weight is assessed as less than 2500 grams. C125481 GAIA Terminology A C128728 GAIA Level 4 Low Birth Weight GAIA Level 4 Low Birth Weight is defined by either one of the following two criteria: one, the newborn's weight is assessed between 3 and 7 days of age, AND weight assessed using any type of scale included in diagnostic level of certainty one, two, or three; OR two, a proxy measure of birth weight is used, AND the weight category is assessed as less than 2500 grams. Level 4 Low Birth Weight Level 4 Low Birth Weight is defined by either one of the following two criteria: one, the newborn's weight is assessed between 3 and 7 days of age, AND weight assessed using any type of scale included in diagnostic level of certainty one, two, or three; OR two, a proxy measure of birth weight is used, AND the weight category is assessed as less than 2500 grams. C125481 GAIA Terminology A C128729 GAIA Level 1 Acute Neonatal Encephalopathy GAIA Level 1 Acute Neonatal Encephalopathy is defined by five criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with electroencephalographic correlation; fourth, difficulty with initiating and maintaining respiration; fifth, depression of muscle tone. Level 1 Acute Neonatal Encephalopathy Level 1 Acute Neonatal Encephalopathy is defined by five criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with electroencephalographic correlation; fourth, difficulty with initiating and maintaining respiration; fifth, depression of muscle tone. C125481 GAIA Terminology A C128730 GAIA Level 2 Acute Neonatal Encephalopathy GAIA Level 2 Acute Neonatal Encephalopathy is defined by four criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with or without electroencephalographic correlation; fourth, either difficulty with initiating and maintaining respiration OR depression of muscle tone. Level 2 Acute Neonatal Encephalopathy Level 2 Acute Neonatal Encephalopathy is defined by four criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with or without electroencephalographic correlation; fourth, either difficulty with initiating and maintaining respiration OR depression of muscle tone. C125481 GAIA Terminology A C128731 GAIA Level 3 Acute Neonatal Encephalopathy GAIA Level 3 Acute Neonatal Encephalopathy is defined by three criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, any of the following: a) clinical seizures; b) difficulty with initiating or maintaining respiration; c) depression of muscle tone. Level 3 Acute Neonatal Encephalopathy Level 3 Acute Neonatal Encephalopathy is defined by three criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, any of the following: a) clinical seizures; b) difficulty with initiating or maintaining respiration; c) depression of muscle tone. C125481 GAIA Terminology A C128733 GAIA Level 1 Small for Gestational Age GAIA Level 1 Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, assessment of weight by both of the following: a) Newborn weighed within 24 hours of birth; AND b) Weight assessed using a calibrated electronic scale with 10 g resolution; third, the gestational age is assessed by confirmatory ultrasound during the first trimester, with or without certain LMP, or IUI or embryo transfer date. Level 1 Small for Gestational Age Level 1 Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, assessment of weight by both of the following: a) Newborn weighed within 24 hours of birth; AND b) Weight assessed using a calibrated electronic scale with 10 g resolution; third, the gestational age is assessed by confirmatory ultrasound during the first trimester, with or without certain LMP, or IUI or embryo transfer date. C125481 GAIA Terminology A C128734 GAIA Level 2a Small for Gestational Age GAIA Level 2a Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, newborn weighed within 24 hours of birth on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, the gestational age is assessed by either a) Certain LMP with first or second trimester ultrasound; or b) Certain LMP with first trimester physical exam. Level 2a Small for Gestational Age Level 2a Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, newborn weighed within 24 hours of birth on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, the gestational age is assessed by either a) Certain LMP with first or second trimester ultrasound; or b) Certain LMP with first trimester physical exam. C125481 GAIA Terminology A C128735 GAIA Level 2b Small for Gestational Age GAIA Level 2b Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, the newborn weighed within 24 hours on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age determined by uncertain LMP with second trimester ultrasound. Level 2b Small for Gestational Age Level 2b Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, the newborn weighed within 24 hours on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age determined by uncertain LMP with second trimester ultrasound. C125481 GAIA Terminology A C128736 GAIA Level 3a Small for Gestational Age GAIA Level 3a Small for Gestational Age is defined by three criteria: first, weight is below the 10th percentile for gestational age; second, the newborn is weighed within the first 48 hours of life on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age assessed by one of the following four methods: a) Certain LMP with third trimester ultrasound; b) Certain LMP with confirmatory 2nd trimester fundal height; c) Certain LMP with birthweight; or d) Uncertain LMP with first trimester physical exam. Level 3a Small for Gestational Age Level 3a Small for Gestational Age is defined by three criteria: first, weight is below the 10th percentile for gestational age; second, the newborn is weighed within the first 48 hours of life on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age assessed by one of the following four methods: a) Certain LMP with third trimester ultrasound; b) Certain LMP with confirmatory 2nd trimester fundal height; c) Certain LMP with birthweight; or d) Uncertain LMP with first trimester physical exam. C125481 GAIA Terminology A C128737 GAIA Level 3b Small for Gestational Age GAIA Level 3b Small for Gestational Age is defined by three criteria: first, the weight is below the 10th percentile for gestational age; second, the infant is weighed within the first 48 hours of life, and the weight is assessed on any scale by measuring the difference between an adult holding the infant and the adult being weighed alone; third, gestational age is assessed by one of following three methods: a) Uncertain LMP with fundal height; b) Uncertain LMP with newborn physical assessment; or c) Uncertain LMP with birthweight. Level 3b Small for Gestational Age Level 3b Small for Gestational Age is defined by three criteria: first, the weight is below the 10th percentile for gestational age; second, the infant is weighed within the first 48 hours of life, and the weight is assessed on any scale by measuring the difference between an adult holding the infant and the adult being weighed alone; third, gestational age is assessed by one of following three methods: a) Uncertain LMP with fundal height; b) Uncertain LMP with newborn physical assessment; or c) Uncertain LMP with birthweight. C125481 GAIA Terminology A C128738 GAIA Level 4 Small for Gestational Age GAIA Level 4 Small for Gestational Age is defined by one of the following three criteria: first, the infant is noted to be small, but has no documented weight; second, the gestational age is assessed by infant examination only; third, the diagnosis is extracted from either billing codes or a chart with no documentation of the actual birth weight or the gestational age. Level 4 Small for Gestational Age Level 4 Small for Gestational Age is defined by one of the following three criteria: first, the infant is noted to be small, but has no documented weight; second, the gestational age is assessed by infant examination only; third, the diagnosis is extracted from either billing codes or a chart with no documentation of the actual birth weight or the gestational age. C125481 GAIA Terminology A C128739 Organic Failure to Thrive Failure to thrive (FTT), that occurs in less than five percent of FTT cases; it is caused by acute or chronic disorders that interfere with nutritional uptake, including cleft palate, malabsorption due to cystic fibrosis, and short gut syndrome. Organic Failure to Thrive Failure to thrive (FTT), that occurs in less than five percent of FTT cases; it is caused by acute or chronic disorders that interfere with nutritional uptake, including cleft palate, malabsorption due to cystic fibrosis, and short gut syndrome. C125481 GAIA Terminology A C128740 Non-Organic Failure to Thrive Failure to thrive caused by inadequate intake due to environmental influences, stimulus deprivation- poverty, feeding techniques, or psychological reason, and without any apparent growth-inhibiting organic disorder. Non-Organic Failure to Thrive Failure to thrive caused by inadequate intake due to environmental influences, stimulus deprivation- poverty, feeding techniques, or psychological reason, and without any apparent growth-inhibiting organic disorder. C125481 GAIA Terminology A C128741 Mixed Failure to Thrive Failure to thrive due to both organic and non-organic causes. Mixed Failure to Thrive Failure to thrive due to both organic and non-organic causes. C125481 GAIA Terminology A C128742 GAIA Level 1 Placenta Previa GAIA Level 1 Placenta Previa is defined by a second or third trimester ultrasound (and/or MRI) that demonstrates evidence of placental tissue overlying or abutting the internal cervical os. Level 1 Placenta Previa Level 1 Placenta Previa is defined by a second or third trimester ultrasound (and/or MRI) that demonstrates evidence of placental tissue overlying or abutting the internal cervical os. C125481 GAIA Terminology A C128743 GAIA Level 2 Placenta Previa GAIA Level 2 Placenta Previa is defined by three criteria: first, painless vaginal bleeding during the second or third trimester; second, a high presenting part or abnormal fetal lie; third, pelvic exam with fullness palpable in the fornices (avoiding digital cervical exam). Level 2 Placenta Previa Level 2 Placenta Previa is defined by three criteria: first, painless vaginal bleeding during the second or third trimester; second, a high presenting part or abnormal fetal lie; third, pelvic exam with fullness palpable in the fornices (avoiding digital cervical exam). C125481 GAIA Terminology A C128744 GAIA Level 1 Morbidly Adherent Placentation GAIA Level 1 Morbidly Adherent Placentation is defined by three criteria: first, evidence of placenta previa by either a second- or third-trimester ultrasound or an MRI; second, one of the following ultrasound features must be present: for Greyscale: a) Loss of the retroplacental sonolucent zone; OR b) Irregular retroplacental sonolucent zone; OR c) Thinning or disruption of the hyperechoic serosa-bladder interface; OR d) Presence of focal exophytic masses invading the urinary bladder; OR e) Abnormal placental lacunae; for Color Doppler: a) Diffuse or focal lacunar flow; OR b) Vascular lakes with turbulent flow (peak systolic velocity over 15 cm/s); OR c) Hypervascularity of serosa-bladder interface; OR d) Markedly dilated vessels over peripheral subplacental zone; for 3D Power Doppler: a) Numerous coherent vessels involving the entire uterine serosa-bladder junction (basal view); OR b) Hypervascularity (lateral view); OR c) Inseparable cotyledonal and intervillous circulations, chaotic branching, and detour vessels (lateral view); third, one of the following risk factors must be present: a) Prior cesarean delivery; OR b) Prior uterine surgery (including endometrial ablation); OR c) Cesarean scar pregnancy. Alternatively, Level 1 may be defined as morbidly adherent placentation found on histology in a hysterectomy or partial wedge resection specimen. Level 1 Morbidly Adherent Placentation Level 1 Morbidly Adherent Placentation is defined by three criteria: first, evidence of placenta previa by either a second- or third-trimester ultrasound or an MRI; second, one of the following ultrasound features must be present: for Greyscale: a) Loss of the retroplacental sonolucent zone; OR b) Irregular retroplacental sonolucent zone; OR c) Thinning or disruption of the hyperechoic serosa-bladder interface; OR d) Presence of focal exophytic masses invading the urinary bladder; OR e) Abnormal placental lacunae; for Color Doppler: a) Diffuse or focal lacunar flow; OR b) Vascular lakes with turbulent flow (peak systolic velocity over 15 cm/s); OR c) Hypervascularity of serosa-bladder interface; OR d) Markedly dilated vessels over peripheral subplacental zone; for 3D Power Doppler: a) Numerous coherent vessels involving the entire uterine serosa-bladder junction (basal view); OR b) Hypervascularity (lateral view); OR c) Inseparable cotyledonal and intervillous circulations, chaotic branching, and detour vessels (lateral view); third, one of the following risk factors must be present: a) Prior cesarean delivery; OR b) Prior uterine surgery (including endometrial ablation); OR c) Cesarean scar pregnancy. Alternatively, Level 1 may be defined as morbidly adherent placentation found on histology in a hysterectomy or partial wedge resection specimen. C125481 GAIA Terminology A C128745 GAIA Level 2 Morbidly Adherent Placentation GAIA Level 2 Morbidly Adherent Placentation is defined by two criteria: first, ultrasound evidence of placenta previa; second, hypervascularity of the lower uterine segment, diagnosed during a laparotomy. Alternatively, Level 2 may be defined as difficulty with placental separation after delivery of the infant, during either a vaginal or a cesarean delivery, with resultant hemorrhage due to partial separation. Level 2 Morbidly Adherent Placentation Level 2 Morbidly Adherent Placentation is defined by two criteria: first, ultrasound evidence of placenta previa; second, hypervascularity of the lower uterine segment, diagnosed during a laparotomy. Alternatively, Level 2 may be defined as difficulty with placental separation after delivery of the infant, during either a vaginal or a cesarean delivery, with resultant hemorrhage due to partial separation. C125481 GAIA Terminology A C128746 GAIA Level 1 Vasa Previa GAIA Level 1 Vasa Previa is defined by two criteria: first, second trimester ultrasound evidence of fetal vessels (vessel with fetal heart rate identified by color flow Doppler) traversing the membranes and overlying the internal cervical os; second, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. Level 1 Vasa Previa Level 1 Vasa Previa is defined by two criteria: first, second trimester ultrasound evidence of fetal vessels (vessel with fetal heart rate identified by color flow Doppler) traversing the membranes and overlying the internal cervical os; second, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. C125481 GAIA Terminology A C128747 GAIA Level 2 Vasa Previa GAIA Level 2 Vasa Previa is defined by four criteria: first, vaginal bleeding during the second or third trimester at the time of ruptured amniotic membranes; second, fetal heart rate changes ultimately resulting in sinusoidal rhythm/terminal bradycardia; third, delivery of one of the following: a) a pale, anemic infant; OR b) a recent stillbirth; OR c) a neonatal death; fourth, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. Level 2 Vasa Previa Level 2 Vasa Previa is defined by four criteria: first, vaginal bleeding during the second or third trimester at the time of ruptured amniotic membranes; second, fetal heart rate changes ultimately resulting in sinusoidal rhythm/terminal bradycardia; third, delivery of one of the following: a) a pale, anemic infant; OR b) a recent stillbirth; OR c) a neonatal death; fourth, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. C125481 GAIA Terminology A C128748 GAIA Level 1 Placental Abruption GAIA Level 1 Placental Abruption is defined by three criteria: first, vaginal bleeding during the second or third trimester in the absence of placenta previa on ultrasound; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor; third, clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 1 may be defined as placental pathology with histologic findings of a chronic abruption. Level 1 Placental Abruption Level 1 Placental Abruption is defined by three criteria: first, vaginal bleeding during the second or third trimester in the absence of placenta previa on ultrasound; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor; third, clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 1 may be defined as placental pathology with histologic findings of a chronic abruption. C125481 GAIA Terminology A C128749 GAIA Level 2 Placental Abruption GAIA Level 2 Placental Abruption is defined by two criteria: first, vaginal bleeding during the second or third trimester; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor without clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 2 may be defined as vaginal bleeding during the second or third trimester with clinical evidence of retroplacental clot or visually evident placental infarcts at the time of delivery. Level 2 Placental Abruption Level 2 Placental Abruption is defined by two criteria: first, vaginal bleeding during the second or third trimester; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor without clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 2 may be defined as vaginal bleeding during the second or third trimester with clinical evidence of retroplacental clot or visually evident placental infarcts at the time of delivery. C125481 GAIA Terminology A C128750 GAIA Level 1 Cesarean Scar Pregnancy GAIA Level 1 Cesarean Scar Pregnancy is defined by a transvaginal ultrasound that demonstrates the following five findings: first, an empty uterine cavity; second, an empty cervical canal, without contact with the gestational sac; third, the presence of a gestational sac, with or without a fetal pole, with or without cardiac activity, in the anterior uterine segment adjacent to the cesarean scar; fourth, an absence of or a defect in the myometrium between the bladder and the gestational sac; fifth, a well-perfused gestational sac as demonstrated by Doppler ultrasound (to differentiate from an expulsing, avascular gestational sac). Alternatively, Level 1 may be defined as a hysterectomy specimen with evidence of a pregnancy implanted into the cesarean scar. Level 1 Cesarean Scar Pregnancy Level 1 Cesarean Scar Pregnancy is defined by a transvaginal ultrasound that demonstrates the following five findings: first, an empty uterine cavity; second, an empty cervical canal, without contact with the gestational sac; third, the presence of a gestational sac, with or without a fetal pole, with or without cardiac activity, in the anterior uterine segment adjacent to the cesarean scar; fourth, an absence of or a defect in the myometrium between the bladder and the gestational sac; fifth, a well-perfused gestational sac as demonstrated by Doppler ultrasound (to differentiate from an expulsing, avascular gestational sac). Alternatively, Level 1 may be defined as a hysterectomy specimen with evidence of a pregnancy implanted into the cesarean scar. C125481 GAIA Terminology A C128751 GAIA Level 1 Intra-abdominal Pregnancy GAIA Level 1 Intra-abdominal Pregnancy is defined by the discovery of a fetus within the abdominal cavity during laparotomy, without evidence of uterine rupture, and with placentation not within the uterine cavity. Level 1 Intra-abdominal Pregnancy Level 1 Intra-abdominal Pregnancy is defined by the discovery of a fetus within the abdominal cavity during laparotomy, without evidence of uterine rupture, and with placentation not within the uterine cavity. C125481 GAIA Terminology A C128752 GAIA Level 1 Uterine Rupture GAIA Level 1 Uterine Rupture is the complete disruption of the uterus, at the time of laparotomy, in the context of vaginal or intra-abdominal bleeding. Level 1 Uterine Rupture Level 1 Uterine Rupture is the complete disruption of the uterus, at the time of laparotomy, in the context of vaginal or intra-abdominal bleeding. C125481 GAIA Terminology A C128753 GAIA Level 1 Gestational Diabetes Mellitus GAIA Level 1 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with level 1 or level 2 certainty, using the GAIA definition for gestational age; third, a diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using venous blood samples. Level 1 Gestational Diabetes Mellitus Level 1 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with level 1 or level 2 certainty, using the GAIA definition for gestational age; third, a diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using venous blood samples. C125481 GAIA Terminology A C128754 GAIA Level 2 Gestational Diabetes Mellitus GAIA Level 2 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third the diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using capillary blood samples. Level 2 Gestational Diabetes Mellitus Level 2 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third the diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using capillary blood samples. C125481 GAIA Terminology A C128755 GAIA Level 3 Gestational Diabetes Mellitus GAIA Level 3 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third, the diagnosis of gestational diabetes as determined by fasting plasma glucose of 5.1-6.9 mmol/l (92-125 mg/dL) using either venous or capillary blood samples. Level 3 Gestational Diabetes Mellitus Level 3 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third, the diagnosis of gestational diabetes as determined by fasting plasma glucose of 5.1-6.9 mmol/l (92-125 mg/dL) using either venous or capillary blood samples. C125481 GAIA Terminology A C128756 GAIA Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus GAIA Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus (GDM) is a category of individuals for whom a diagnosis of GDM cannot be made due to one of the following: a) the blood glucose cannot be measured; b) the use of Hemoglobin A1c alone, without a diagnostic oral glucose tolerance test (OGTT) or elevated fasting plasma glucose level; c) clinical and laboratory findings, including glucosuria, fundal height greater than dates, obesity, prior history of GDM, or family history for the diagnosis of gestational diabetes mellitus, without a diagnostic test. Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus (GDM) is a category of individuals for whom a diagnosis of GDM cannot be made due to one of the following: a) the blood glucose cannot be measured; b) the use of Hemoglobin A1c alone, without a diagnostic oral glucose tolerance test (OGTT) or elevated fasting plasma glucose level; c) clinical and laboratory findings, including glucosuria, fundal height greater than dates, obesity, prior history of GDM, or family history for the diagnosis of gestational diabetes mellitus, without a diagnostic test. C125481 GAIA Terminology A C128757 GAIA Level 1 Postnatally Diagnosed Congenital Microcephaly GAIA Level 1 Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks Gestational Age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, the measurement is taken between 24-36 hours after birth or at the end of the pregnancy. Level 1 Postnatally Diagnosed Congenital Microcephaly Level 1 Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks Gestational Age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, the measurement is taken between 24-36 hours after birth or at the end of the pregnancy. C125481 GAIA Terminology A C128758 GAIA Level 2A Postnatally Diagnosed Congenital Microcephaly GAIA Level 2A Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. Level 2A Postnatally Diagnosed Congenital Microcephaly Level 2A Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. C125481 GAIA Terminology A C128759 GAIA Level 2B Postnatally Diagnosed Congenital Microcephaly GAIA Level 2B Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks of gestational age (GA), as assessed by uncertain last menstrual period (LMP) date with 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. Level 2B Postnatally Diagnosed Congenital Microcephaly Level 2B Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks of gestational age (GA), as assessed by uncertain last menstrual period (LMP) date with 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. C125481 GAIA Terminology A C128760 GAIA Level 3 Postnatally Diagnosed Congenital Microcephaly GAIA Level 3 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, the case meets the criteria for microcephaly using the following validated algorithm: one inpatient diagnosis; OR two outpatient diagnoses; OR one outpatient diagnosis AND death in first year using the following diagnostic codes: ICD-9-CM code 742.1 or ICD-10-CM code Q02. Level 3 Postnatally Diagnosed Congenital Microcephaly Level 3 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, the case meets the criteria for microcephaly using the following validated algorithm: one inpatient diagnosis; OR two outpatient diagnoses; OR one outpatient diagnosis AND death in first year using the following diagnostic codes: ICD-9-CM code 742.1 or ICD-10-CM code Q02. C125481 GAIA Terminology A C128761 GAIA Level 4 Postnatally Diagnosed Congenital Microcephaly GAIA Level 4 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, a diagnosis of congenital microcephaly based on either a physical inspection without head circumference (HC) measurement, OR an ICD-9-CM or ICD-10-CM code that does not meet the validated algorithm criteria used in the case definition for GAIA Level 3 Postnatally Diagnosed Congenital Microcephaly. Level 4 Postnatally Diagnosed Congenital Microcephaly Level 4 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, a diagnosis of congenital microcephaly based on either a physical inspection without head circumference (HC) measurement, OR an ICD-9-CM or ICD-10-CM code that does not meet the validated algorithm criteria used in the case definition for Level 3 Postnatally Diagnosed Congenital Microcephaly. C125481 GAIA Terminology A C128762 GAIA Level 1a Prenatally Diagnosed Congenital Microcephaly GAIA Level 1A Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. Level 1a Prenatally Diagnosed Congenital Microcephaly Level 1A Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. C125481 GAIA Terminology A C128763 GAIA Level 1b Prenatally Diagnosed Congenital Microcephaly GAIA Level 1B Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on uncertain last menstrual period (LMP) date with a 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. Level 1b Prenatally Diagnosed Congenital Microcephaly Level 1B Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on uncertain last menstrual period (LMP) date with a 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. C125481 GAIA Terminology A C128764 GAIA Level 2 Prenatally Diagnosed Congenital Microcephaly GAIA Level 2 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on last menstrual period (LMP) date with fundal height and no confirmatory ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. Level 2 Prenatally Diagnosed Congenital Microcephaly Level 2 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on last menstrual period (LMP) date with fundal height and no confirmatory ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. C125481 GAIA Terminology A C128765 GAIA Level 3 Prenatally Diagnosed Congenital Microcephaly GAIA Level 3 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. Level 3 Prenatally Diagnosed Congenital Microcephaly Level 3 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. C125481 GAIA Terminology A C128766 GAIA Level 4 Prenatally Diagnosed Congenital Microcephaly GAIA Level 4 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI), OR embryo transfer date; second, no available measurement of head circumference (HC) in utero by US, but documentation in the medical record suggesting microcephaly based on US imaging; third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. Level 4 Prenatally Diagnosed Congenital Microcephaly Level 4 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI), OR embryo transfer date; second, no available measurement of head circumference (HC) in utero by US, but documentation in the medical record suggesting microcephaly based on US imaging; third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. C125481 GAIA Terminology A C128767 GAIA Level 5 Prenatally Diagnosed Congenital Microcephaly GAIA Level 5 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, HC at birth or autopsy is within the normal range, using appropriate, standardized reference charts according to GA and gender for the population, which means that this is NOT a case of prenatally diagnosed congenital microcephaly. Level 5 Prenatally Diagnosed Congenital Microcephaly Level 5 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, HC at birth or autopsy is within the normal range, using appropriate, standardized reference charts according to GA and gender for the population, which means that this is NOT a case of prenatally diagnosed congenital microcephaly. C125481 GAIA Terminology A C128768 GAIA Level 1 Neonatal Respiratory Distress GAIA Level 1 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, the presence of any one of the following three symptoms that indicate an abnormal respiratory rate: a) Tachypnea (respiratory rate of more than 60 breaths per minute); b) Bradypnea (respiratory rate of less than 30 breaths per minute); c) Apnea [cessation of respiratory effort (no breaths) for at least 20 seconds]; third, one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch); d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes, with respiration score less than 2; fourth, examination and documentation by qualified, trained health care providers who are appropriate for the clinical setting. Level 1 Neonatal Respiratory Distress Level 1 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, the presence of any one of the following three symptoms that indicate an abnormal respiratory rate: a) Tachypnea (respiratory rate of more than 60 breaths per minute); b) Bradypnea (respiratory rate of less than 30 breaths per minute); c) Apnea [cessation of respiratory effort (no breaths) for at least 20 seconds]; third, one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch); d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes, with respiration score less than 2; fourth, examination and documentation by qualified, trained health care providers who are appropriate for the clinical setting. C125481 GAIA Terminology A C128769 GAIA Level 2 Neonatal Respiratory Distress GAIA Level 2 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, an abnormal respiratory rate (not measured, but reported as rapid breathing, slow breathing, having periods of no breathing, or abnormal breathing); third, the presence of any one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch) or seesaw respirations; d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes with a respiration score less than 2; fourth, one of the following two requirements: a) No medical record documentaion, but reporting through either a non-medical observer (e.g., mother, father, community worker) or via standard census mechanisms (e.g., Demographic and Health Surveillance System), or b) Collection of information from medical review or billing codes. Level 2 Neonatal Respiratory Distress Level 2 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, an abnormal respiratory rate (not measured, but reported as rapid breathing, slow breathing, having periods of no breathing, or abnormal breathing); third, the presence of any one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch) or seesaw respirations; d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes with a respiration score less than 2; fourth, one of the following two requirements: a) No medical record documentaion, but reporting through either a non-medical observer (e.g., mother, father, community worker) or via standard census mechanisms (e.g., Demographic and Health Surveillance System), or b) Collection of information from medical review or billing codes. C125481 GAIA Terminology A C128770 GAIA Level 1 Failure to Thrive GAIA Level 1 Failure to Thrive is defined by four criteria: first, the infant's age is determined by a documented birth date; second, weights are obtained using an electronic scale; third, a minimum of two documented weights measured at least four weeks apart; fourth, the weight for age deceleration must pass through at least two centile spaces on a growth chart. Level 1 Failure to Thrive Level 1 Failure to Thrive is defined by four criteria: first, the infant's age is determined by a documented birth date; second, weights are obtained using an electronic scale; third, a minimum of two documented weights measured at least four weeks apart; fourth, the weight for age deceleration must pass through at least two centile spaces on a growth chart. C125481 GAIA Terminology A C128771 GAIA Level 2a Failure to Thrive GAIA Level 2a Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a beam balance scale; c) A minimum of two documented weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following four requirements must be present: a) Infants have an undocumented birth date, where age is determined based on mother's recall to the nearest month; b) Weights are obtained using an electronic scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart. Level 2a Failure to Thrive Level 2a Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a beam balance scale; c) A minimum of two documented weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following four requirements must be present: a) Infants have an undocumented birth date, where age is determined based on mother's recall to the nearest month; b) Weights are obtained using an electronic scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart. C125481 GAIA Terminology A C128772 GAIA Level 2b Failure to Thrive GAIA Level 2b Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a spring balance scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following three requirements must be present: a) Weight is measured using an electronic scale or beam balance scale; b) Length is documented using infantometer; c) Weight for length ratio less than or equal to the third centile on an appropriate growth chart. Level 2b Failure to Thrive Level 2b Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a spring balance scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following three requirements must be present: a) Weight is measured using an electronic scale or beam balance scale; b) Length is documented using infantometer; c) Weight for length ratio less than or equal to the third centile on an appropriate growth chart. C125481 GAIA Terminology A C128773 GAIA Level 3a Failure to Thrive GAIA Level 3a Failure to Thrive is defined by four criteria: first, infants with an undocumented birth date, where age is determined based on mother's recall to the nearest month; second, weight obtained using either beam balance or spring balance scale; third, a minimum of two weights measured at least four weeks apart; fourth, weight for age deceleration must pass through at least two centile spaces on a growth chart. Level 3a Failure to Thrive Level 3a Failure to Thrive is defined by four criteria: first, infants with an undocumented birth date, where age is determined based on mother's recall to the nearest month; second, weight obtained using either beam balance or spring balance scale; third, a minimum of two weights measured at least four weeks apart; fourth, weight for age deceleration must pass through at least two centile spaces on a growth chart. C125481 GAIA Terminology A C128774 GAIA Level 3b Failure to Thrive GAIA Level 3b Failure to Thrive is defined by three criteria: first, infants have no weight available; second, physical examination is consistent with failure to thrive, which is defined as having at least two findings, one of which must be a major finding: reduced subcutaneous fat stores, poor muscle mass, loose skin folds, prominent ribs, and thin limbs. Less specific findings include sparse hair, rashes, pallor, irritable temperment, and lethargy/fatigue; third, a mid-upper arm circumference (MUAC) measurement, which is indicative of severe wasting, that is less than or equal to 110 mm in infants up to six months of age, and that is less than or equal to 115 mm in infants six to twelve months of age. Level 3b Failure to Thrive Level 3b Failure to Thrive is defined by three criteria: first, infants have no weight available; second, physical examination is consistent with failure to thrive, which is defined as having at least two findings, one of which must be a major finding: reduced subcutaneous fat stores, poor muscle mass, loose skin folds, prominent ribs, and thin limbs. Less specific findings include sparse hair, rashes, pallor, irritable temperment, and lethargy/fatigue; third, a mid-upper arm circumference (MUAC) measurement, which is indicative of severe wasting, that is less than or equal to 110 mm in infants up to six months of age, and that is less than or equal to 115 mm in infants six to twelve months of age. C125481 GAIA Terminology A C128775 First Trimester Spontaneous Abortion Pregnancy loss at less than 14 weeks 0 days gestation. First Trimester Spontaneous Abortion Pregnancy loss at less than 14 weeks 0 days gestation. C125481 GAIA Terminology A C128776 GAIA Level 1 First Trimester Spontaneous Abortion GAIA Level 1 First Trimester Spontaneous Abortion is defined by three criteria: first, at least one of the following requirements must be met: a) Crown-rump length greater than or equal to 7 mm and no visible heartbeat on transvaginal ultrasound; OR b) Crown-rump length greater than or equal to 15 mm and no visible heartbeat on abdominal ultrasound; OR c) Ultrasound examination demonstrating mean gestational sac diameter greater than or equal to 25 mm and no visible embryo or yolk sac; second, at least one of the following requirements must be met: a) A second transvaginal ultrasound performed greater than or equal to 7 days later (or 14 days later if transabdominal) confirming the diagnosis of a non-viable pregnancy; OR b) The absence of an embryo with heartbeat 2 weeks or more after a transabdominal scan that initially showed a gestational sac without a yolk sac; OR c) The absence of an embryo with a heartbeat 11 days or more after a transvaginal scan that initially showed a gestational sac with a yolk sac; OR d) Positive urine or blood pregnancy test that becomes negative after 7 days; OR e) Products of conception found on histopathological evaluation of pregnancy tissue; OR f) Ultrasound examination demonstrating an empty uterine cavity in a woman who had clear evidence of intrauterine pregnancy on previous ultrasound examination; OR g) Vaginal bleeding, external cervical os open or closed, with visible expulsion of pregnancy tissues/products of conception; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 1 First Trimester Spontaneous Abortion Level 1 First Trimester Spontaneous Abortion is defined by three criteria: first, at least one of the following requirements must be met: a) Crown-rump length greater than or equal to 7 mm and no visible heartbeat on transvaginal ultrasound; OR b) Crown-rump length greater than or equal to 15 mm and no visible heartbeat on abdominal ultrasound; OR c) Ultrasound examination demonstrating mean gestational sac diameter greater than or equal to 25 mm and no visible embryo or yolk sac; second, at least one of the following requirements must be met: a) A second transvaginal ultrasound performed greater than or equal to 7 days later (or 14 days later if transabdominal) confirming the diagnosis of a non-viable pregnancy; OR b) The absence of an embryo with heartbeat 2 weeks or more after a transabdominal scan that initially showed a gestational sac without a yolk sac; OR c) The absence of an embryo with a heartbeat 11 days or more after a transvaginal scan that initially showed a gestational sac with a yolk sac; OR d) Positive urine or blood pregnancy test that becomes negative after 7 days; OR e) Products of conception found on histopathological evaluation of pregnancy tissue; OR f) Ultrasound examination demonstrating an empty uterine cavity in a woman who had clear evidence of intrauterine pregnancy on previous ultrasound examination; OR g) Vaginal bleeding, external cervical os open or closed, with visible expulsion of pregnancy tissues/products of conception; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C125481 GAIA Terminology A C128777 GAIA Level 2 First Trimester Spontaneous Abortion GAIA Level 2 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as a Level 1 First Trimester Spontaneous Abortion; second, at least one of the following requirements must be met: a) Crown-rump length greater than 7 mm and no visible heartbeat, confirmed by transvaginal ultrasound; OR b) Crown-rump length greater than 15 mm and no visible heartbeat, confirmed by abdominal ultrasound; OR c) Mean gestational sac diameter is 25 mm or more and no visible embryo; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 2 First Trimester Spontaneous Abortion Level 2 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as a Level 1 First Trimester Spontaneous Abortion; second, at least one of the following requirements must be met: a) Crown-rump length greater than 7 mm and no visible heartbeat, confirmed by transvaginal ultrasound; OR b) Crown-rump length greater than 15 mm and no visible heartbeat, confirmed by abdominal ultrasound; OR c) Mean gestational sac diameter is 25 mm or more and no visible embryo; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C125481 GAIA Terminology A C128778 GAIA Level 3 First Trimester Spontaneous Abortion GAIA Level 3 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as either a Level 1 or Level 2 First Trimester Spontaneous Abortion; second, a positive urine or blood pregnancy test that becomes negative after 7 days; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). Level 3 First Trimester Spontaneous Abortion Level 3 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as either a Level 1 or Level 2 First Trimester Spontaneous Abortion; second, a positive urine or blood pregnancy test that becomes negative after 7 days; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). C125481 GAIA Terminology A C128779 GAIA Level 4 First Trimester Spontaneous Abortion GAIA Level 4 First Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 First Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. Level 4 First Trimester Spontaneous Abortion Level 4 First Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 First Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. C125481 GAIA Terminology A C128780 Second Trimester Spontaneous Abortion Pregnancy loss between 14 weeks 0 days and 21 weeks 6 days gestation. Second Trimester Spontaneous Abortion Pregnancy loss between 14 weeks 0 days and 21 weeks 6 days gestation. C125481 GAIA Terminology A C128781 GAIA Level 1 Second Trimester Spontaneous Abortion GAIA Level 1 Second Trimester Spontaneous Abortion is defined by two criteria: first, at least one of the following requirements must be met: a) No visible heartbeat on ultrasound; OR b) Visible expulsion of pregnancy tissues/products of conception on examination of the cervix; OR c) Products of conception found on histopathological evaluation of uterine contents; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 1 Second Trimester Spontaneous Abortion Level 1 Second Trimester Spontaneous Abortion is defined by two criteria: first, at least one of the following requirements must be met: a) No visible heartbeat on ultrasound; OR b) Visible expulsion of pregnancy tissues/products of conception on examination of the cervix; OR c) Products of conception found on histopathological evaluation of uterine contents; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C125481 GAIA Terminology A C128782 GAIA Level 2 Second Trimester Spontaneous Abortion GAIA Level 2 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1 Second Trimester Spontaneous Abortion; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). Level 2 Second Trimester Spontaneous Abortion Level 2 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1 Second Trimester Spontaneous Abortion; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). C125481 GAIA Terminology A C128783 GAIA Level 4 Second Trimester Spontaneous Abortion GAIA Level 4 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as either a Level 1 or a Level 2 Second Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. Level 4 Second Trimester Spontaneous Abortion Level 4 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as either a Level 1 or a Level 2 Second Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. C125481 GAIA Terminology A C128915 GAIA Insufficient Evidence for Fetal Growth Restriction GAIA Insufficient Evidence for Fetal Growth Restriction is defined as the absence of an ultrasound for use in the assessment of estimated fetal weight. Insufficient Evidence for Fetal Growth Restriction Insufficient Evidence for Fetal Growth Restriction is defined as the absence of an ultrasound for use in the assessment of estimated fetal weight. C125481 GAIA Terminology A C26685 Placental Abruption Placental separation from the uterus with bleeding (concealed or vaginal) before fetal birth, with or without maternal/fetal compromise. (reVITALize) Placental Abruption A condition in which the placenta detaches prematurely from its implantation site. C125481 GAIA Terminology A C26858 Placenta Previa A condition in which the placenta covers or is within 1 cm of the cervical os. Placenta Previa A condition in which the placenta partially or completely overlies the internal cervical os. C125481 GAIA Terminology A C34336 Spontaneous Abortion Fetal loss at less than 20 weeks of gestation. Spontaneous Abortion Early pregnancy loss. C125481 GAIA Terminology A C34724 Low Birth Weight A birth weight that is less than 2500 grams. Low Birth Weight C125481 GAIA Terminology A C34945 Ectopic Pregnancy An abnormal pregnancy in which the conception is implanted outside the endometrial cavity. Ectopic Pregnancy A pregnancy that implants in a location other than the uterine endometrium. C125481 GAIA Terminology A C87127 Vasa Previa Umbilical blood vessels that have inserted into the amniotic membrane (membranous insertion) that in turn are above or adjacent to the cervical os and are at risk of rupture. Vasa Previa A condition in which fetal blood vessels reside within the amniotic membranes and traverse either across the internal cervical os or within 2 centimeters of the os. C125481 GAIA Terminology A C92921 Abdominal Pregnancy Ectopic pregnancy characterized by the implantation of the embryo in the peritoneal cavity or abdominal organs. Intra-abdominal Pregnancy A rare form of an ectopic pregnancy, in which a pregnancy implants into the peritoneal cavity or into the abdominal organs. C125481 GAIA Terminology A C128729 GAIA Level 1 Acute Neonatal Encephalopathy GAIA Level 1 Acute Neonatal Encephalopathy is defined by five criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with electroencephalographic correlation; fourth, difficulty with initiating and maintaining respiration; fifth, depression of muscle tone. Level 1 Acute Neonatal Encephalopathy Level 1 Acute Neonatal Encephalopathy is defined by five criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with electroencephalographic correlation; fourth, difficulty with initiating and maintaining respiration; fifth, depression of muscle tone. C128699 GAIA Acute Neonatal Encephalopathy Level of Diagnostic Certainty Terminology A C128730 GAIA Level 2 Acute Neonatal Encephalopathy GAIA Level 2 Acute Neonatal Encephalopathy is defined by four criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with or without electroencephalographic correlation; fourth, either difficulty with initiating and maintaining respiration OR depression of muscle tone. Level 2 Acute Neonatal Encephalopathy Level 2 Acute Neonatal Encephalopathy is defined by four criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, clinical seizures with or without electroencephalographic correlation; fourth, either difficulty with initiating and maintaining respiration OR depression of muscle tone. C128699 GAIA Acute Neonatal Encephalopathy Level of Diagnostic Certainty Terminology A C128731 GAIA Level 3 Acute Neonatal Encephalopathy GAIA Level 3 Acute Neonatal Encephalopathy is defined by three criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, any of the following: a) clinical seizures; b) difficulty with initiating or maintaining respiration; c) depression of muscle tone. Level 3 Acute Neonatal Encephalopathy Level 3 Acute Neonatal Encephalopathy is defined by three criteria: first, an infant born at or beyond 35 weeks of gestation; second, an abnormal level of alertness; third, any of the following: a) clinical seizures; b) difficulty with initiating or maintaining respiration; c) depression of muscle tone. C128699 GAIA Acute Neonatal Encephalopathy Level of Diagnostic Certainty Terminology A C128757 GAIA Level 1 Postnatally Diagnosed Congenital Microcephaly GAIA Level 1 Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks Gestational Age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, the measurement is taken between 24-36 hours after birth or at the end of the pregnancy. Level 1 Postnatally Diagnosed Congenital Microcephaly Level 1 Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks Gestational Age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, the measurement is taken between 24-36 hours after birth or at the end of the pregnancy. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128758 GAIA Level 2A Postnatally Diagnosed Congenital Microcephaly GAIA Level 2A Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. Level 2A Postnatally Diagnosed Congenital Microcephaly Level 2A Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128759 GAIA Level 2B Postnatally Diagnosed Congenital Microcephaly GAIA Level 2B Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks of gestational age (GA), as assessed by uncertain last menstrual period (LMP) date with 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. Level 2B Postnatally Diagnosed Congenital Microcephaly Level 2B Postnatally Diagnosed Congenital Microcephaly is defined by three criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion of at least 24 weeks of gestational age (GA), as assessed by uncertain last menstrual period (LMP) date with 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile as assessed by GA and gender, using appropriate, standardized reference charts for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, one of the following requirements is met: a) the measurement is taken within the first 24 hours after birth or at the end of the pregnancy; OR b) the measurement is taken greater than 36 hours and up to 6 weeks after birth or the end of the pregnancy with no apparent post-natal insult resulting in microcephaly. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128760 GAIA Level 3 Postnatally Diagnosed Congenital Microcephaly GAIA Level 3 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, the case meets the criteria for microcephaly using the following validated algorithm: one inpatient diagnosis; OR two outpatient diagnoses; OR one outpatient diagnosis AND death in first year using the following diagnostic codes: ICD-9-CM code 742.1 or ICD-10-CM code Q02. Level 3 Postnatally Diagnosed Congenital Microcephaly Level 3 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, the case meets the criteria for microcephaly using the following validated algorithm: one inpatient diagnosis; OR two outpatient diagnoses; OR one outpatient diagnosis AND death in first year using the following diagnostic codes: ICD-9-CM code 742.1 or ICD-10-CM code Q02. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128761 GAIA Level 4 Postnatally Diagnosed Congenital Microcephaly GAIA Level 4 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, a diagnosis of congenital microcephaly based on either a physical inspection without head circumference (HC) measurement, OR an ICD-9-CM or ICD-10-CM code that does not meet the validated algorithm criteria used in the case definition for GAIA Level 3 Postnatally Diagnosed Congenital Microcephaly. Level 4 Postnatally Diagnosed Congenital Microcephaly Level 4 Postnatally Diagnosed Congenital Microcephaly is defined by two criteria: first, a live birth, stillbirth, or spontaneous or therapeutic abortion; second, a diagnosis of congenital microcephaly based on either a physical inspection without head circumference (HC) measurement, OR an ICD-9-CM or ICD-10-CM code that does not meet the validated algorithm criteria used in the case definition for Level 3 Postnatally Diagnosed Congenital Microcephaly. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128762 GAIA Level 1a Prenatally Diagnosed Congenital Microcephaly GAIA Level 1A Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. Level 1a Prenatally Diagnosed Congenital Microcephaly Level 1A Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA assessed by either a certain last menstrual period (LMP) date with confirmatory 1st trimester (less than 14 weeks) or 2nd trimester ultrasound (US) scan OR intrauterine insemination (IUI) or embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128763 GAIA Level 1b Prenatally Diagnosed Congenital Microcephaly GAIA Level 1B Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on uncertain last menstrual period (LMP) date with a 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. Level 1b Prenatally Diagnosed Congenital Microcephaly Level 1B Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on uncertain last menstrual period (LMP) date with a 2nd trimester ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128764 GAIA Level 2 Prenatally Diagnosed Congenital Microcephaly GAIA Level 2 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on last menstrual period (LMP) date with fundal height and no confirmatory ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. Level 2 Prenatally Diagnosed Congenital Microcephaly Level 2 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA) based on last menstrual period (LMP) date with fundal height and no confirmatory ultrasound (US) scan; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, confirmation of microcephaly (i.e., HC 2 SD below the mean or less than 3%) in the fetus by either at least one additional US after 24 weeks that occurs at least one week after the first US, OR confirmation of microcephaly by HC measurement with a standard tape measure at either birth or autopsy. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128765 GAIA Level 3 Prenatally Diagnosed Congenital Microcephaly GAIA Level 3 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. Level 3 Prenatally Diagnosed Congenital Microcephaly Level 3 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128766 GAIA Level 4 Prenatally Diagnosed Congenital Microcephaly GAIA Level 4 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI), OR embryo transfer date; second, no available measurement of head circumference (HC) in utero by US, but documentation in the medical record suggesting microcephaly based on US imaging; third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. Level 4 Prenatally Diagnosed Congenital Microcephaly Level 4 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI), OR embryo transfer date; second, no available measurement of head circumference (HC) in utero by US, but documentation in the medical record suggesting microcephaly based on US imaging; third, no confirmation of microcephaly with any additional US or by HC measurement at either birth or autopsy. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C128767 GAIA Level 5 Prenatally Diagnosed Congenital Microcephaly GAIA Level 5 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, HC at birth or autopsy is within the normal range, using appropriate, standardized reference charts according to GA and gender for the population, which means that this is NOT a case of prenatally diagnosed congenital microcephaly. Level 5 Prenatally Diagnosed Congenital Microcephaly Level 5 Prenatally Diagnosed Congenital Microcephaly is defined by three criteria: first, the fetus is at least 24 weeks gestational age (GA), with GA based on last menstrual period (LMP) date, OR first trimester ultrasound (US) scan, OR intrauterine insemination (IUI) OR embryo transfer date; second, a head circumference (HC) measurement either 2 standard deviations (SD) below the mean or less than the third percentile according to fetal US examination, using appropriate, standardized reference charts according to GA and gender for the population (e.g. WHO growth reference charts if GA greater than or equal to 37 weeks and Intergrowth-21st reference charts for GA 24-36 weeks); third, HC at birth or autopsy is within the normal range, using appropriate, standardized reference charts according to GA and gender for the population, which means that this is NOT a case of prenatally diagnosed congenital microcephaly. C128700 GAIA Congenital Microcephaly Level of Diagnostic Certainty Terminology A C114935 Very Low Birth Weight Birth weight less than 1500 grams. Very Low Birth Weight C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C114936 Extremely Low Birth Weight Birth weight less than 1000 grams. Extremely Low Birth Weight C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C128725 GAIA Level 1 Low Birth Weight GAIA Level 1 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; an electronic scale that is graduated to 10 grams is used; the scale is calibrated at least once a year; the scale is placed on level, hard surface; the scale is tared to zero grams; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 5 of diagnostic level of certainty one. Level 1 Low Birth Weight Level 1 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; an electronic scale that is graduated to 10 grams is used; the scale is calibrated at least once a year; the scale is placed on level, hard surface; the scale is tared to zero grams; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 5 of diagnostic level of certainty one. C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C128726 GAIA Level 2 Low Birth Weight GAIA Level 2 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; either an electronic or a spring scale that is graduated to 50 grams is used; the scale is calibrated at least once a year, or more often if moved; the scale is tared to zero grams or 0.00 kg; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 4 of diagnostic level of certainty two. Level 2 Low Birth Weight Level 2 Low Birth Weight is defined by the presence of either one of the following two criteria: one, a newborn infant is weighed within 24 hours of birth; either an electronic or a spring scale that is graduated to 50 grams is used; the scale is calibrated at least once a year, or more often if moved; the scale is tared to zero grams or 0.00 kg; the birth weight recorded is less than 2500 grams; OR two, a birth weight is recorded as less than 2500 grams as assessed per the health care facility's standard operating procedure, which fulfills criteria 1 to 4 of diagnostic level of certainty two. C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C128727 GAIA Level 3 Low Birth Weight GAIA Level 3 Low Birth Weight is defined by three criteria: first, a newborn infant must be weighed within the first 48 hours of life; second, weight is measured using a dial/ spring/ color-coded scale; third, weight is assessed as less than 2500 grams. Level 3 Low Birth Weight Level 3 Low Birth Weight is defined by three criteria: first, a newborn infant must be weighed within the first 48 hours of life; second, weight is measured using a dial/ spring/ color-coded scale; third, weight is assessed as less than 2500 grams. C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C128728 GAIA Level 4 Low Birth Weight GAIA Level 4 Low Birth Weight is defined by either one of the following two criteria: one, the newborn's weight is assessed between 3 and 7 days of age, AND weight assessed using any type of scale included in diagnostic level of certainty one, two, or three; OR two, a proxy measure of birth weight is used, AND the weight category is assessed as less than 2500 grams. Level 4 Low Birth Weight Level 4 Low Birth Weight is defined by either one of the following two criteria: one, the newborn's weight is assessed between 3 and 7 days of age, AND weight assessed using any type of scale included in diagnostic level of certainty one, two, or three; OR two, a proxy measure of birth weight is used, AND the weight category is assessed as less than 2500 grams. C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C34724 Low Birth Weight A birth weight that is less than 2500 grams. Low Birth Weight C128701 GAIA Low Birth Weight Level of Diagnostic Certainty Terminology A C128768 GAIA Level 1 Neonatal Respiratory Distress GAIA Level 1 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, the presence of any one of the following three symptoms that indicate an abnormal respiratory rate: a) Tachypnea (respiratory rate of more than 60 breaths per minute); b) Bradypnea (respiratory rate of less than 30 breaths per minute); c) Apnea [cessation of respiratory effort (no breaths) for at least 20 seconds]; third, one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch); d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes, with respiration score less than 2; fourth, examination and documentation by qualified, trained health care providers who are appropriate for the clinical setting. Level 1 Neonatal Respiratory Distress Level 1 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, the presence of any one of the following three symptoms that indicate an abnormal respiratory rate: a) Tachypnea (respiratory rate of more than 60 breaths per minute); b) Bradypnea (respiratory rate of less than 30 breaths per minute); c) Apnea [cessation of respiratory effort (no breaths) for at least 20 seconds]; third, one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch); d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes, with respiration score less than 2; fourth, examination and documentation by qualified, trained health care providers who are appropriate for the clinical setting. C128702 GAIA Neonatal Respiratory Distress Level of Diagnostic Certainty Terminology A C128769 GAIA Level 2 Neonatal Respiratory Distress GAIA Level 2 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, an abnormal respiratory rate (not measured, but reported as rapid breathing, slow breathing, having periods of no breathing, or abnormal breathing); third, the presence of any one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch) or seesaw respirations; d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes with a respiration score less than 2; fourth, one of the following two requirements: a) No medical record documentaion, but reporting through either a non-medical observer (e.g., mother, father, community worker) or via standard census mechanisms (e.g., Demographic and Health Surveillance System), or b) Collection of information from medical review or billing codes. Level 2 Neonatal Respiratory Distress Level 2 Neonatal Respiratory Distress is defined by four criteria: first, the newborn must be between 0 and 28 days of life; second, an abnormal respiratory rate (not measured, but reported as rapid breathing, slow breathing, having periods of no breathing, or abnormal breathing); third, the presence of any one of the following five clinical symptoms that indicate labored breathing: a) Nasal flaring (dilatation of alae nasi); b) Noisy respirations in the form of expiratory grunting, stridor, or wheeze; c) Retractions or increased chest indrawings on inspiration (subcostal, intercostal, sternal, suprasternal notch) or seesaw respirations; d) Central cyanosis (whole body, including lips and tongue) on room air; e) Low Apgar score (less than 7 points) at 10 minutes with a respiration score less than 2; fourth, one of the following two requirements: a) No medical record documentaion, but reporting through either a non-medical observer (e.g., mother, father, community worker) or via standard census mechanisms (e.g., Demographic and Health Surveillance System), or b) Collection of information from medical review or billing codes. C128702 GAIA Neonatal Respiratory Distress Level of Diagnostic Certainty Terminology A C128733 GAIA Level 1 Small for Gestational Age GAIA Level 1 Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, assessment of weight by both of the following: a) Newborn weighed within 24 hours of birth; AND b) Weight assessed using a calibrated electronic scale with 10 g resolution; third, the gestational age is assessed by confirmatory ultrasound during the first trimester, with or without certain LMP, or IUI or embryo transfer date. Level 1 Small for Gestational Age Level 1 Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, assessment of weight by both of the following: a) Newborn weighed within 24 hours of birth; AND b) Weight assessed using a calibrated electronic scale with 10 g resolution; third, the gestational age is assessed by confirmatory ultrasound during the first trimester, with or without certain LMP, or IUI or embryo transfer date. C128703 GAIA Small for Gestational Age Level of Diagnostic Certainty Terminology A C128734 GAIA Level 2a Small for Gestational Age GAIA Level 2a Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, newborn weighed within 24 hours of birth on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, the gestational age is assessed by either a) Certain LMP with first or second trimester ultrasound; or b) Certain LMP with first trimester physical exam. Level 2a Small for Gestational Age Level 2a Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, newborn weighed within 24 hours of birth on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, the gestational age is assessed by either a) Certain LMP with first or second trimester ultrasound; or b) Certain LMP with first trimester physical exam. C128703 GAIA Small for Gestational Age Level of Diagnostic Certainty Terminology A C128735 GAIA Level 2b Small for Gestational Age GAIA Level 2b Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, the newborn weighed within 24 hours on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age determined by uncertain LMP with second trimester ultrasound. Level 2b Small for Gestational Age Level 2b Small for Gestational Age is defined by three criteria: first, weight below the 10th percentile for gestational age; second, the newborn weighed within 24 hours on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age determined by uncertain LMP with second trimester ultrasound. C128703 GAIA Small for Gestational Age Level of Diagnostic Certainty Terminology A C128736 GAIA Level 3a Small for Gestational Age GAIA Level 3a Small for Gestational Age is defined by three criteria: first, weight is below the 10th percentile for gestational age; second, the newborn is weighed within the first 48 hours of life on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age assessed by one of the following four methods: a) Certain LMP with third trimester ultrasound; b) Certain LMP with confirmatory 2nd trimester fundal height; c) Certain LMP with birthweight; or d) Uncertain LMP with first trimester physical exam. Level 3a Small for Gestational Age Level 3a Small for Gestational Age is defined by three criteria: first, weight is below the 10th percentile for gestational age; second, the newborn is weighed within the first 48 hours of life on any scale with a less than or equal to 50 g resolution, calibrated and tared to zero; third, gestational age assessed by one of the following four methods: a) Certain LMP with third trimester ultrasound; b) Certain LMP with confirmatory 2nd trimester fundal height; c) Certain LMP with birthweight; or d) Uncertain LMP with first trimester physical exam. C128703 GAIA Small for Gestational Age Level of Diagnostic Certainty Terminology A C128737 GAIA Level 3b Small for Gestational Age GAIA Level 3b Small for Gestational Age is defined by three criteria: first, the weight is below the 10th percentile for gestational age; second, the infant is weighed within the first 48 hours of life, and the weight is assessed on any scale by measuring the difference between an adult holding the infant and the adult being weighed alone; third, gestational age is assessed by one of following three methods: a) Uncertain LMP with fundal height; b) Uncertain LMP with newborn physical assessment; or c) Uncertain LMP with birthweight. Level 3b Small for Gestational Age Level 3b Small for Gestational Age is defined by three criteria: first, the weight is below the 10th percentile for gestational age; second, the infant is weighed within the first 48 hours of life, and the weight is assessed on any scale by measuring the difference between an adult holding the infant and the adult being weighed alone; third, gestational age is assessed by one of following three methods: a) Uncertain LMP with fundal height; b) Uncertain LMP with newborn physical assessment; or c) Uncertain LMP with birthweight. C128703 GAIA Small for Gestational Age Level of Diagnostic Certainty Terminology A C128738 GAIA Level 4 Small for Gestational Age GAIA Level 4 Small for Gestational Age is defined by one of the following three criteria: first, the infant is noted to be small, but has no documented weight; second, the gestational age is assessed by infant examination only; third, the diagnosis is extracted from either billing codes or a chart with no documentation of the actual birth weight or the gestational age. Level 4 Small for Gestational Age Level 4 Small for Gestational Age is defined by one of the following three criteria: first, the infant is noted to be small, but has no documented weight; second, the gestational age is assessed by infant examination only; third, the diagnosis is extracted from either billing codes or a chart with no documentation of the actual birth weight or the gestational age. C128703 GAIA Small for Gestational Age Level of Diagnostic Certainty Terminology A C113099 Pediatric Failure to Thrive Less than normal weight gain in an infant or child, which may include poor linear and head growth. Failure to Thrive C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128739 Organic Failure to Thrive Failure to thrive (FTT), that occurs in less than five percent of FTT cases; it is caused by acute or chronic disorders that interfere with nutritional uptake, including cleft palate, malabsorption due to cystic fibrosis, and short gut syndrome. Organic Failure to Thrive Failure to thrive (FTT), that occurs in less than five percent of FTT cases; it is caused by acute or chronic disorders that interfere with nutritional uptake, including cleft palate, malabsorption due to cystic fibrosis, and short gut syndrome. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128740 Non-Organic Failure to Thrive Failure to thrive caused by inadequate intake due to environmental influences, stimulus deprivation- poverty, feeding techniques, or psychological reason, and without any apparent growth-inhibiting organic disorder. Non-Organic Failure to Thrive Failure to thrive caused by inadequate intake due to environmental influences, stimulus deprivation- poverty, feeding techniques, or psychological reason, and without any apparent growth-inhibiting organic disorder. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128741 Mixed Failure to Thrive Failure to thrive due to both organic and non-organic causes. Mixed Failure to Thrive Failure to thrive due to both organic and non-organic causes. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128770 GAIA Level 1 Failure to Thrive GAIA Level 1 Failure to Thrive is defined by four criteria: first, the infant's age is determined by a documented birth date; second, weights are obtained using an electronic scale; third, a minimum of two documented weights measured at least four weeks apart; fourth, the weight for age deceleration must pass through at least two centile spaces on a growth chart. Level 1 Failure to Thrive Level 1 Failure to Thrive is defined by four criteria: first, the infant's age is determined by a documented birth date; second, weights are obtained using an electronic scale; third, a minimum of two documented weights measured at least four weeks apart; fourth, the weight for age deceleration must pass through at least two centile spaces on a growth chart. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128771 GAIA Level 2a Failure to Thrive GAIA Level 2a Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a beam balance scale; c) A minimum of two documented weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following four requirements must be present: a) Infants have an undocumented birth date, where age is determined based on mother's recall to the nearest month; b) Weights are obtained using an electronic scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart. Level 2a Failure to Thrive Level 2a Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a beam balance scale; c) A minimum of two documented weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following four requirements must be present: a) Infants have an undocumented birth date, where age is determined based on mother's recall to the nearest month; b) Weights are obtained using an electronic scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128772 GAIA Level 2b Failure to Thrive GAIA Level 2b Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a spring balance scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following three requirements must be present: a) Weight is measured using an electronic scale or beam balance scale; b) Length is documented using infantometer; c) Weight for length ratio less than or equal to the third centile on an appropriate growth chart. Level 2b Failure to Thrive Level 2b Failure to Thrive is defined by either of two criteria: one, the following four requirements must be present: a) Infant age determined by a documented birth date; b) Weights are obtained using a spring balance scale; c) A minimum of two weights measured at least four weeks apart; d) Weight for age deceleration must pass through at least two centile spaces on a growth chart; OR two, the following three requirements must be present: a) Weight is measured using an electronic scale or beam balance scale; b) Length is documented using infantometer; c) Weight for length ratio less than or equal to the third centile on an appropriate growth chart. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128773 GAIA Level 3a Failure to Thrive GAIA Level 3a Failure to Thrive is defined by four criteria: first, infants with an undocumented birth date, where age is determined based on mother's recall to the nearest month; second, weight obtained using either beam balance or spring balance scale; third, a minimum of two weights measured at least four weeks apart; fourth, weight for age deceleration must pass through at least two centile spaces on a growth chart. Level 3a Failure to Thrive Level 3a Failure to Thrive is defined by four criteria: first, infants with an undocumented birth date, where age is determined based on mother's recall to the nearest month; second, weight obtained using either beam balance or spring balance scale; third, a minimum of two weights measured at least four weeks apart; fourth, weight for age deceleration must pass through at least two centile spaces on a growth chart. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128774 GAIA Level 3b Failure to Thrive GAIA Level 3b Failure to Thrive is defined by three criteria: first, infants have no weight available; second, physical examination is consistent with failure to thrive, which is defined as having at least two findings, one of which must be a major finding: reduced subcutaneous fat stores, poor muscle mass, loose skin folds, prominent ribs, and thin limbs. Less specific findings include sparse hair, rashes, pallor, irritable temperment, and lethargy/fatigue; third, a mid-upper arm circumference (MUAC) measurement, which is indicative of severe wasting, that is less than or equal to 110 mm in infants up to six months of age, and that is less than or equal to 115 mm in infants six to twelve months of age. Level 3b Failure to Thrive Level 3b Failure to Thrive is defined by three criteria: first, infants have no weight available; second, physical examination is consistent with failure to thrive, which is defined as having at least two findings, one of which must be a major finding: reduced subcutaneous fat stores, poor muscle mass, loose skin folds, prominent ribs, and thin limbs. Less specific findings include sparse hair, rashes, pallor, irritable temperment, and lethargy/fatigue; third, a mid-upper arm circumference (MUAC) measurement, which is indicative of severe wasting, that is less than or equal to 110 mm in infants up to six months of age, and that is less than or equal to 115 mm in infants six to twelve months of age. C128704 GAIA Failure to Thrive Level of Diagnostic Certainty Terminology A C128710 GAIA Level 1 Ectopic Pregnancy GAIA Level 1 Ectopic Pregnancy is defined by two criteria: first, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) Transvaginal Ultrasound showing extrauterine pregnancy; OR c) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; second, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 1 Ectopic Pregnancy Level 1 Ectopic Pregnancy is defined by two criteria: first, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) Transvaginal Ultrasound showing extrauterine pregnancy; OR c) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; second, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128711 GAIA Level 2 Ectopic Pregnancy GAIA Level 2 Ectopic Pregnancy is defined by three criteria: first, it does not qualify as a Level 1 Ectopic Pregnancy; second, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; third, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 2 Ectopic Pregnancy Level 2 Ectopic Pregnancy is defined by three criteria: first, it does not qualify as a Level 1 Ectopic Pregnancy; second, at least one of the following requirements must be met: a) B-HCG serum blood test greater than 2000 mIU/ml with transvaginal ultrasound showing no intrauterine pregnancy; OR b) B-HCG serum blood test greater than 2000 mIU/ml with no products of conception found on endometrial curettage after a dilation and curettage procedure; third, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128712 GAIA Level 3 Ectopic Pregnancy GAIA Level 3 Ectopic Pregnancy is defined by four criteria: first, it does not qualify as either a Level 1 or a Level 2 Ectopic Pregnancy; second, a positive urine pregnancy test; third, no products of conception are found on endometrial curettage after a dilation and curettage procedure; fourth, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 2 or 3). Level 3 Ectopic Pregnancy Level 3 Ectopic Pregnancy is defined by four criteria: first, it does not qualify as either a Level 1 or a Level 2 Ectopic Pregnancy; second, a positive urine pregnancy test; third, no products of conception are found on endometrial curettage after a dilation and curettage procedure; fourth, gestational age is within the pre-defined range for the selected ectopic pregnancy definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 2 or 3). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128713 GAIA Level 4 Ectopic Pregnancy GAIA Level 4 Ectopic Pregnancy is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 Ectopic Pregnancy; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. Level 4 Ectopic Pregnancy Level 4 Ectopic Pregnancy is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 Ectopic Pregnancy; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128775 First Trimester Spontaneous Abortion Pregnancy loss at less than 14 weeks 0 days gestation. First Trimester Spontaneous Abortion Pregnancy loss at less than 14 weeks 0 days gestation. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128776 GAIA Level 1 First Trimester Spontaneous Abortion GAIA Level 1 First Trimester Spontaneous Abortion is defined by three criteria: first, at least one of the following requirements must be met: a) Crown-rump length greater than or equal to 7 mm and no visible heartbeat on transvaginal ultrasound; OR b) Crown-rump length greater than or equal to 15 mm and no visible heartbeat on abdominal ultrasound; OR c) Ultrasound examination demonstrating mean gestational sac diameter greater than or equal to 25 mm and no visible embryo or yolk sac; second, at least one of the following requirements must be met: a) A second transvaginal ultrasound performed greater than or equal to 7 days later (or 14 days later if transabdominal) confirming the diagnosis of a non-viable pregnancy; OR b) The absence of an embryo with heartbeat 2 weeks or more after a transabdominal scan that initially showed a gestational sac without a yolk sac; OR c) The absence of an embryo with a heartbeat 11 days or more after a transvaginal scan that initially showed a gestational sac with a yolk sac; OR d) Positive urine or blood pregnancy test that becomes negative after 7 days; OR e) Products of conception found on histopathological evaluation of pregnancy tissue; OR f) Ultrasound examination demonstrating an empty uterine cavity in a woman who had clear evidence of intrauterine pregnancy on previous ultrasound examination; OR g) Vaginal bleeding, external cervical os open or closed, with visible expulsion of pregnancy tissues/products of conception; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 1 First Trimester Spontaneous Abortion Level 1 First Trimester Spontaneous Abortion is defined by three criteria: first, at least one of the following requirements must be met: a) Crown-rump length greater than or equal to 7 mm and no visible heartbeat on transvaginal ultrasound; OR b) Crown-rump length greater than or equal to 15 mm and no visible heartbeat on abdominal ultrasound; OR c) Ultrasound examination demonstrating mean gestational sac diameter greater than or equal to 25 mm and no visible embryo or yolk sac; second, at least one of the following requirements must be met: a) A second transvaginal ultrasound performed greater than or equal to 7 days later (or 14 days later if transabdominal) confirming the diagnosis of a non-viable pregnancy; OR b) The absence of an embryo with heartbeat 2 weeks or more after a transabdominal scan that initially showed a gestational sac without a yolk sac; OR c) The absence of an embryo with a heartbeat 11 days or more after a transvaginal scan that initially showed a gestational sac with a yolk sac; OR d) Positive urine or blood pregnancy test that becomes negative after 7 days; OR e) Products of conception found on histopathological evaluation of pregnancy tissue; OR f) Ultrasound examination demonstrating an empty uterine cavity in a woman who had clear evidence of intrauterine pregnancy on previous ultrasound examination; OR g) Vaginal bleeding, external cervical os open or closed, with visible expulsion of pregnancy tissues/products of conception; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128777 GAIA Level 2 First Trimester Spontaneous Abortion GAIA Level 2 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as a Level 1 First Trimester Spontaneous Abortion; second, at least one of the following requirements must be met: a) Crown-rump length greater than 7 mm and no visible heartbeat, confirmed by transvaginal ultrasound; OR b) Crown-rump length greater than 15 mm and no visible heartbeat, confirmed by abdominal ultrasound; OR c) Mean gestational sac diameter is 25 mm or more and no visible embryo; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 2 First Trimester Spontaneous Abortion Level 2 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as a Level 1 First Trimester Spontaneous Abortion; second, at least one of the following requirements must be met: a) Crown-rump length greater than 7 mm and no visible heartbeat, confirmed by transvaginal ultrasound; OR b) Crown-rump length greater than 15 mm and no visible heartbeat, confirmed by abdominal ultrasound; OR c) Mean gestational sac diameter is 25 mm or more and no visible embryo; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128778 GAIA Level 3 First Trimester Spontaneous Abortion GAIA Level 3 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as either a Level 1 or Level 2 First Trimester Spontaneous Abortion; second, a positive urine or blood pregnancy test that becomes negative after 7 days; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). Level 3 First Trimester Spontaneous Abortion Level 3 First Trimester Spontaneous Abortion is defined by three criteria: first, it does not qualify as either a Level 1 or Level 2 First Trimester Spontaneous Abortion; second, a positive urine or blood pregnancy test that becomes negative after 7 days; third, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128779 GAIA Level 4 First Trimester Spontaneous Abortion GAIA Level 4 First Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 First Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. Level 4 First Trimester Spontaneous Abortion Level 4 First Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1, a Level 2, or a Level 3 First Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128780 Second Trimester Spontaneous Abortion Pregnancy loss between 14 weeks 0 days and 21 weeks 6 days gestation. Second Trimester Spontaneous Abortion Pregnancy loss between 14 weeks 0 days and 21 weeks 6 days gestation. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128781 GAIA Level 1 Second Trimester Spontaneous Abortion GAIA Level 1 Second Trimester Spontaneous Abortion is defined by two criteria: first, at least one of the following requirements must be met: a) No visible heartbeat on ultrasound; OR b) Visible expulsion of pregnancy tissues/products of conception on examination of the cervix; OR c) Products of conception found on histopathological evaluation of uterine contents; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). Level 1 Second Trimester Spontaneous Abortion Level 1 Second Trimester Spontaneous Abortion is defined by two criteria: first, at least one of the following requirements must be met: a) No visible heartbeat on ultrasound; OR b) Visible expulsion of pregnancy tissues/products of conception on examination of the cervix; OR c) Products of conception found on histopathological evaluation of uterine contents; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 1 or 2). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128782 GAIA Level 2 Second Trimester Spontaneous Abortion GAIA Level 2 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1 Second Trimester Spontaneous Abortion; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). Level 2 Second Trimester Spontaneous Abortion Level 2 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as a Level 1 Second Trimester Spontaneous Abortion; second, gestational age is within the pre-defined range for the selected abortion definition as assessed by maternal and/or fetal parameters (Brighton Preterm Birth Gestational Age algorithm level of certainty 3). C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C128783 GAIA Level 4 Second Trimester Spontaneous Abortion GAIA Level 4 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as either a Level 1 or a Level 2 Second Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. Level 4 Second Trimester Spontaneous Abortion Level 4 Second Trimester Spontaneous Abortion is defined by two criteria: first, it does not qualify as either a Level 1 or a Level 2 Second Trimester Spontaneous Abortion; second, a maternal self-report or documentation in the medical record of a pregnancy loss without sufficient ultrasound or laboratory evidence to confirm. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C34336 Spontaneous Abortion Fetal loss at less than 20 weeks of gestation. Spontaneous Abortion Early pregnancy loss. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C34945 Ectopic Pregnancy An abnormal pregnancy in which the conception is implanted outside the endometrial cavity. Ectopic Pregnancy A pregnancy that implants in a location other than the uterine endometrium. C128705 GAIA Spontaneous Abortion and Ectopic Pregnancy Level of Diagnostic Certainty Terminology A C114371 Antepartum Hemorrhage Excessive blood loss prior to onset of labor. Antenatal Bleeding A clinical syndrome that is characterized by bleeding during the second or third trimester of pregnancy. Pathologic etiologies attributable to the pregnant state include placenta previa, morbidly adherent placenta, vasa previa, placental abruption, cesarean scar pregnancy, intra-abdominal pregnancy, and uterine rupture. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128714 Morbidly Adherent Placenta A condition in which the placenta implants abnormally into the uterine myometrium, rather than implanting into the uterine decidua basalis as is normal. Morbidly Adherent Placentation A condition in which the placenta implants abnormally into the uterine myometrium, rather than implanting into the uterine decidua basalis as is normal. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128715 Cesarean Scar Pregnancy An ectopic pregnancy implanted in a previous cesarean (hysterotomy) scar, surrounded by myometrium and connective tissue. Cesarean Scar Pregnancy An ectopic pregnancy implanted in a previous cesarean (hysterotomy) scar, surrounded by myometrium and connective tissue. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128716 Uterine Rupture The complete, nonsurgical disruption of all layers of the uterus. Uterine Rupture The complete, nonsurgical disruption of all layers of the uterus. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128742 GAIA Level 1 Placenta Previa GAIA Level 1 Placenta Previa is defined by a second or third trimester ultrasound (and/or MRI) that demonstrates evidence of placental tissue overlying or abutting the internal cervical os. Level 1 Placenta Previa Level 1 Placenta Previa is defined by a second or third trimester ultrasound (and/or MRI) that demonstrates evidence of placental tissue overlying or abutting the internal cervical os. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128743 GAIA Level 2 Placenta Previa GAIA Level 2 Placenta Previa is defined by three criteria: first, painless vaginal bleeding during the second or third trimester; second, a high presenting part or abnormal fetal lie; third, pelvic exam with fullness palpable in the fornices (avoiding digital cervical exam). Level 2 Placenta Previa Level 2 Placenta Previa is defined by three criteria: first, painless vaginal bleeding during the second or third trimester; second, a high presenting part or abnormal fetal lie; third, pelvic exam with fullness palpable in the fornices (avoiding digital cervical exam). C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128744 GAIA Level 1 Morbidly Adherent Placentation GAIA Level 1 Morbidly Adherent Placentation is defined by three criteria: first, evidence of placenta previa by either a second- or third-trimester ultrasound or an MRI; second, one of the following ultrasound features must be present: for Greyscale: a) Loss of the retroplacental sonolucent zone; OR b) Irregular retroplacental sonolucent zone; OR c) Thinning or disruption of the hyperechoic serosa-bladder interface; OR d) Presence of focal exophytic masses invading the urinary bladder; OR e) Abnormal placental lacunae; for Color Doppler: a) Diffuse or focal lacunar flow; OR b) Vascular lakes with turbulent flow (peak systolic velocity over 15 cm/s); OR c) Hypervascularity of serosa-bladder interface; OR d) Markedly dilated vessels over peripheral subplacental zone; for 3D Power Doppler: a) Numerous coherent vessels involving the entire uterine serosa-bladder junction (basal view); OR b) Hypervascularity (lateral view); OR c) Inseparable cotyledonal and intervillous circulations, chaotic branching, and detour vessels (lateral view); third, one of the following risk factors must be present: a) Prior cesarean delivery; OR b) Prior uterine surgery (including endometrial ablation); OR c) Cesarean scar pregnancy. Alternatively, Level 1 may be defined as morbidly adherent placentation found on histology in a hysterectomy or partial wedge resection specimen. Level 1 Morbidly Adherent Placentation Level 1 Morbidly Adherent Placentation is defined by three criteria: first, evidence of placenta previa by either a second- or third-trimester ultrasound or an MRI; second, one of the following ultrasound features must be present: for Greyscale: a) Loss of the retroplacental sonolucent zone; OR b) Irregular retroplacental sonolucent zone; OR c) Thinning or disruption of the hyperechoic serosa-bladder interface; OR d) Presence of focal exophytic masses invading the urinary bladder; OR e) Abnormal placental lacunae; for Color Doppler: a) Diffuse or focal lacunar flow; OR b) Vascular lakes with turbulent flow (peak systolic velocity over 15 cm/s); OR c) Hypervascularity of serosa-bladder interface; OR d) Markedly dilated vessels over peripheral subplacental zone; for 3D Power Doppler: a) Numerous coherent vessels involving the entire uterine serosa-bladder junction (basal view); OR b) Hypervascularity (lateral view); OR c) Inseparable cotyledonal and intervillous circulations, chaotic branching, and detour vessels (lateral view); third, one of the following risk factors must be present: a) Prior cesarean delivery; OR b) Prior uterine surgery (including endometrial ablation); OR c) Cesarean scar pregnancy. Alternatively, Level 1 may be defined as morbidly adherent placentation found on histology in a hysterectomy or partial wedge resection specimen. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128745 GAIA Level 2 Morbidly Adherent Placentation GAIA Level 2 Morbidly Adherent Placentation is defined by two criteria: first, ultrasound evidence of placenta previa; second, hypervascularity of the lower uterine segment, diagnosed during a laparotomy. Alternatively, Level 2 may be defined as difficulty with placental separation after delivery of the infant, during either a vaginal or a cesarean delivery, with resultant hemorrhage due to partial separation. Level 2 Morbidly Adherent Placentation Level 2 Morbidly Adherent Placentation is defined by two criteria: first, ultrasound evidence of placenta previa; second, hypervascularity of the lower uterine segment, diagnosed during a laparotomy. Alternatively, Level 2 may be defined as difficulty with placental separation after delivery of the infant, during either a vaginal or a cesarean delivery, with resultant hemorrhage due to partial separation. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128746 GAIA Level 1 Vasa Previa GAIA Level 1 Vasa Previa is defined by two criteria: first, second trimester ultrasound evidence of fetal vessels (vessel with fetal heart rate identified by color flow Doppler) traversing the membranes and overlying the internal cervical os; second, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. Level 1 Vasa Previa Level 1 Vasa Previa is defined by two criteria: first, second trimester ultrasound evidence of fetal vessels (vessel with fetal heart rate identified by color flow Doppler) traversing the membranes and overlying the internal cervical os; second, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128747 GAIA Level 2 Vasa Previa GAIA Level 2 Vasa Previa is defined by four criteria: first, vaginal bleeding during the second or third trimester at the time of ruptured amniotic membranes; second, fetal heart rate changes ultimately resulting in sinusoidal rhythm/terminal bradycardia; third, delivery of one of the following: a) a pale, anemic infant; OR b) a recent stillbirth; OR c) a neonatal death; fourth, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. Level 2 Vasa Previa Level 2 Vasa Previa is defined by four criteria: first, vaginal bleeding during the second or third trimester at the time of ruptured amniotic membranes; second, fetal heart rate changes ultimately resulting in sinusoidal rhythm/terminal bradycardia; third, delivery of one of the following: a) a pale, anemic infant; OR b) a recent stillbirth; OR c) a neonatal death; fourth, post-delivery examination of the placental specimen that demonstrates unsupported fetal vessels within the membranes. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128748 GAIA Level 1 Placental Abruption GAIA Level 1 Placental Abruption is defined by three criteria: first, vaginal bleeding during the second or third trimester in the absence of placenta previa on ultrasound; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor; third, clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 1 may be defined as placental pathology with histologic findings of a chronic abruption. Level 1 Placental Abruption Level 1 Placental Abruption is defined by three criteria: first, vaginal bleeding during the second or third trimester in the absence of placenta previa on ultrasound; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor; third, clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 1 may be defined as placental pathology with histologic findings of a chronic abruption. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128749 GAIA Level 2 Placental Abruption GAIA Level 2 Placental Abruption is defined by two criteria: first, vaginal bleeding during the second or third trimester; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor without clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 2 may be defined as vaginal bleeding during the second or third trimester with clinical evidence of retroplacental clot or visually evident placental infarcts at the time of delivery. Level 2 Placental Abruption Level 2 Placental Abruption is defined by two criteria: first, vaginal bleeding during the second or third trimester; second, uterine irritability (irregular, frequent uterine activity, not coalesced into clear contractions in a regular pattern) or labor without clinical signs of hypovolemic shock or coagulopathy. Alternatively, Level 2 may be defined as vaginal bleeding during the second or third trimester with clinical evidence of retroplacental clot or visually evident placental infarcts at the time of delivery. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128750 GAIA Level 1 Cesarean Scar Pregnancy GAIA Level 1 Cesarean Scar Pregnancy is defined by a transvaginal ultrasound that demonstrates the following five findings: first, an empty uterine cavity; second, an empty cervical canal, without contact with the gestational sac; third, the presence of a gestational sac, with or without a fetal pole, with or without cardiac activity, in the anterior uterine segment adjacent to the cesarean scar; fourth, an absence of or a defect in the myometrium between the bladder and the gestational sac; fifth, a well-perfused gestational sac as demonstrated by Doppler ultrasound (to differentiate from an expulsing, avascular gestational sac). Alternatively, Level 1 may be defined as a hysterectomy specimen with evidence of a pregnancy implanted into the cesarean scar. Level 1 Cesarean Scar Pregnancy Level 1 Cesarean Scar Pregnancy is defined by a transvaginal ultrasound that demonstrates the following five findings: first, an empty uterine cavity; second, an empty cervical canal, without contact with the gestational sac; third, the presence of a gestational sac, with or without a fetal pole, with or without cardiac activity, in the anterior uterine segment adjacent to the cesarean scar; fourth, an absence of or a defect in the myometrium between the bladder and the gestational sac; fifth, a well-perfused gestational sac as demonstrated by Doppler ultrasound (to differentiate from an expulsing, avascular gestational sac). Alternatively, Level 1 may be defined as a hysterectomy specimen with evidence of a pregnancy implanted into the cesarean scar. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128751 GAIA Level 1 Intra-abdominal Pregnancy GAIA Level 1 Intra-abdominal Pregnancy is defined by the discovery of a fetus within the abdominal cavity during laparotomy, without evidence of uterine rupture, and with placentation not within the uterine cavity. Level 1 Intra-abdominal Pregnancy Level 1 Intra-abdominal Pregnancy is defined by the discovery of a fetus within the abdominal cavity during laparotomy, without evidence of uterine rupture, and with placentation not within the uterine cavity. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C128752 GAIA Level 1 Uterine Rupture GAIA Level 1 Uterine Rupture is the complete disruption of the uterus, at the time of laparotomy, in the context of vaginal or intra-abdominal bleeding. Level 1 Uterine Rupture Level 1 Uterine Rupture is the complete disruption of the uterus, at the time of laparotomy, in the context of vaginal or intra-abdominal bleeding. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C26685 Placental Abruption Placental separation from the uterus with bleeding (concealed or vaginal) before fetal birth, with or without maternal/fetal compromise. (reVITALize) Placental Abruption A condition in which the placenta detaches prematurely from its implantation site. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C26858 Placenta Previa A condition in which the placenta covers or is within 1 cm of the cervical os. Placenta Previa A condition in which the placenta partially or completely overlies the internal cervical os. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C87127 Vasa Previa Umbilical blood vessels that have inserted into the amniotic membrane (membranous insertion) that in turn are above or adjacent to the cervical os and are at risk of rupture. Vasa Previa A condition in which fetal blood vessels reside within the amniotic membranes and traverse either across the internal cervical os or within 2 centimeters of the os. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C92921 Abdominal Pregnancy Ectopic pregnancy characterized by the implantation of the embryo in the peritoneal cavity or abdominal organs. Intra-abdominal Pregnancy A rare form of an ectopic pregnancy, in which a pregnancy implants into the peritoneal cavity or into the abdominal organs. C128706 GAIA Antenatal Bleeding Level of Diagnostic Certainty Terminology A C113492 Dysfunctional Labor Uterine contractions (less than 3 in 10 minutes or inadequate strength) that do not result in progressive cervical dilation. Dysfunctional Labor Prolongation in the duration of labor, typically during the first stage of labor. Diagnosis of a delay in labor is dependent upon careful monitoring of uterine contraction intensity, duration, and frequency, cervical dilation, and the descent of the fetus through the pelvis. C128707 GAIA Dysfunctional Bleeding Level of Diagnostic Certainty Terminology A C128717 GAIA Level 1 Dysfunctional First Stage of Labor GAIA Level 1 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) and with confirmed ruptured membranes. Level 1 Dysfunctional First Stage of Labor Level 1 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) and with confirmed ruptured membranes. C128707 GAIA Dysfunctional Bleeding Level of Diagnostic Certainty Terminology A C128718 GAIA Level 2 Dysfunctional First Stage of Labor GAIA Level 2 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) without certainty of ruptured membranes. Level 2 Dysfunctional First Stage of Labor Level 2 Dysfunctional First Stage of Labor is defined by progress of less than 0.5 cm of cervical dilation per hour, for at least 4 hours, in women with established labor (i.e. have regular contractions and cervical dilation of at least 4 cm) without certainty of ruptured membranes. C128707 GAIA Dysfunctional Bleeding Level of Diagnostic Certainty Terminology A C128719 GAIA Level 1 Dysfunctional Second Stage of Labor GAIA Level 1 Dysfunctional Second Stage of Labor is defined by three criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus); second, the onset of the active stage of labor (active maternal effort (i.e. pushing) or visible baby); third, at least one of the following requirements must be met: a) Greater than 2 hours of pushing (in nulliparous women); OR b) Greater than 1 hour of pushing (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. Level 1 Dysfunctional Second Stage of Labor Level 1 Dysfunctional Second Stage of Labor is defined by three criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus); second, the onset of the active stage of labor (active maternal effort (i.e. pushing) or visible baby); third, at least one of the following requirements must be met: a) Greater than 2 hours of pushing (in nulliparous women); OR b) Greater than 1 hour of pushing (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. C128707 GAIA Dysfunctional Bleeding Level of Diagnostic Certainty Terminology A C128720 GAIA Level 2 Dysfunctional Second Stage of Labor GAIA Level 2 Dysfunctional Second Stage of Labor is defined by two criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus) during any phase of the second stage of labor; second, at least one of the following requirements must be met: a) No delivery within 3 hours of full dilation (in nulliparous women); OR b) No delivery with 2 hours of full dilation (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. Level 2 Dysfunctional Second Stage of Labor Level 2 Dysfunctional Second Stage of Labor is defined by two criteria: first, full dilation of the cervix (10 cm dilated, or no palpable cervix around the presenting part of the fetus) during any phase of the second stage of labor; second, at least one of the following requirements must be met: a) No delivery within 3 hours of full dilation (in nulliparous women); OR b) No delivery with 2 hours of full dilation (in multiparous women); OR c) The use of an instrument (forceps or vacuum/ventouse); OR d) Cesarean delivery for the indication of dystocia. C128707 GAIA Dysfunctional Bleeding Level of Diagnostic Certainty Terminology A C114875 Fetus Small for Gestational Age A fetus that does not grow beyond the 10th percentile of conventionally accepted weight for gestational age. Fetal Growth Restriction A fetus with a sonographic estimation of fetal weight below the tenth percentile for a given gestational age, with increasing specificity for adverse perinatal outcomes below the third percentile. C128708 GAIA Fetal Growth Restriction Level of Diagnostic Certainty Terminology A C128721 GAIA Level 1a Fetal Growth Restriction GAIA Level 1a Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Level 1a Fetal Growth Restriction Level 1a Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. C128708 GAIA Fetal Growth Restriction Level of Diagnostic Certainty Terminology A C128722 GAIA Level 1b Fetal Growth Restriction GAIA Level 1b Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Level 1b Fetal Growth Restriction Level 1b Fetal Growth Restriction is defined by two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. C128708 GAIA Fetal Growth Restriction Level of Diagnostic Certainty Terminology A C128723 GAIA Level 2a Fetal Growth Restriction GAIA Level 2a Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Level 2a Fetal Growth Restriction Level 2a Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the third percentile using locally-accepted growth curve; OR b) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either findings of absent or reversed end-diastolic flow of the umbilical artery Doppler OR a finding of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. C128708 GAIA Fetal Growth Restriction Level of Diagnostic Certainty Terminology A C128724 GAIA Level 2b Fetal Growth Restriction GAIA Level 2b Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Alternatively, Level 2b may be defined by the following two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve, and absence of oligohydramnios as defined by amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2, and the inability to assess umbilical artery Doppler. Level 2b Fetal Growth Restriction Level 2b Fetal Growth Restriction is defined by two criteria: first, Level 2 evidence of pregnancy dating; second, at least one of the following requirements must be met: a) Estimated fetal weight below the tenth percentile using locally-accepted growth curve AND either the absence or reversal of end-diastolic flow of the umbilical artery Doppler OR the absence of oligohydramnios as defined by an amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2. Alternatively, Level 2b may be defined by the following two criteria: first, Level 1 evidence of pregnancy dating; second, an estimated fetal weight below the tenth percentile using locally-accepted growth curve, and absence of oligohydramnios as defined by amniotic fluid index (AFI) less than 8 or deepest vertical pocket (DVP) less than 2, and the inability to assess umbilical artery Doppler. C128708 GAIA Fetal Growth Restriction Level of Diagnostic Certainty Terminology A C128915 GAIA Insufficient Evidence for Fetal Growth Restriction GAIA Insufficient Evidence for Fetal Growth Restriction is defined as the absence of an ultrasound for use in the assessment of estimated fetal weight. Insufficient Evidence for Fetal Growth Restriction Insufficient Evidence for Fetal Growth Restriction is defined as the absence of an ultrasound for use in the assessment of estimated fetal weight. C128708 GAIA Fetal Growth Restriction Level of Diagnostic Certainty Terminology A C128753 GAIA Level 1 Gestational Diabetes Mellitus GAIA Level 1 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with level 1 or level 2 certainty, using the GAIA definition for gestational age; third, a diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using venous blood samples. Level 1 Gestational Diabetes Mellitus Level 1 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with level 1 or level 2 certainty, using the GAIA definition for gestational age; third, a diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using venous blood samples. C128709 GAIA Gestational Diabetes Mellitus Level of Diagnostic Certainty Terminology A C128754 GAIA Level 2 Gestational Diabetes Mellitus GAIA Level 2 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third the diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using capillary blood samples. Level 2 Gestational Diabetes Mellitus Level 2 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third the diagnosis of gestational diabetes as determined by a positive result from an international standard oral glucose tolerance test using capillary blood samples. C128709 GAIA Gestational Diabetes Mellitus Level of Diagnostic Certainty Terminology A C128755 GAIA Level 3 Gestational Diabetes Mellitus GAIA Level 3 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third, the diagnosis of gestational diabetes as determined by fasting plasma glucose of 5.1-6.9 mmol/l (92-125 mg/dL) using either venous or capillary blood samples. Level 3 Gestational Diabetes Mellitus Level 3 Gestational Diabetes Mellitus is defined by three criteria: first, at least one of the following requirements must be met: a) the absence of a previous diagnosis of diabetes while not pregnant; b) a first trimester hemoglobin A1c level of greater than or equal to 6.5% (47.5 mmol/mol); c) a first trimester fasting blood glucose greater than or equal to 126 mg/dL (greater than 7mmol/L); second, gestational age with at least level 3 certainty, using the GAIA definition for gestational age; third, the diagnosis of gestational diabetes as determined by fasting plasma glucose of 5.1-6.9 mmol/l (92-125 mg/dL) using either venous or capillary blood samples. C128709 GAIA Gestational Diabetes Mellitus Level of Diagnostic Certainty Terminology A C128756 GAIA Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus GAIA Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus (GDM) is a category of individuals for whom a diagnosis of GDM cannot be made due to one of the following: a) the blood glucose cannot be measured; b) the use of Hemoglobin A1c alone, without a diagnostic oral glucose tolerance test (OGTT) or elevated fasting plasma glucose level; c) clinical and laboratory findings, including glucosuria, fundal height greater than dates, obesity, prior history of GDM, or family history for the diagnosis of gestational diabetes mellitus, without a diagnostic test. Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus Insufficient Evidence for Diagnosis of Gestational Diabetes Mellitus (GDM) is a category of individuals for whom a diagnosis of GDM cannot be made due to one of the following: a) the blood glucose cannot be measured; b) the use of Hemoglobin A1c alone, without a diagnostic oral glucose tolerance test (OGTT) or elevated fasting plasma glucose level; c) clinical and laboratory findings, including glucosuria, fundal height greater than dates, obesity, prior history of GDM, or family history for the diagnosis of gestational diabetes mellitus, without a diagnostic test. C128709 GAIA Gestational Diabetes Mellitus Level of Diagnostic Certainty Terminology C C127944 GAIA Level 1 Assessment of Premature Preterm Rupture of Membranes GAIA Level 1 Assessment of Premature Preterm Rupture of Membranes is defined by five criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the two following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than 2); fifth, documentation of the membrane rupture by one of the following diagnostic tests: a) Positive intra-amniotic dye-injection method; b) Positive result on amniotic fluid alpha-fetoprotein test kit; c) Amniotic fluid pH measurement (nitrazine paper test); d) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); e) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). Level 1 Assessment of Premature Preterm Rupture of Membranes Level 1 Assessment of Premature Preterm Rupture of Membranes is defined by five criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the two following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than 2); fifth, documentation of the membrane rupture by one of the following diagnostic tests: a) Positive intra-amniotic dye-injection method; b) Positive result on amniotic fluid alpha-fetoprotein test kit; c) Amniotic fluid pH measurement (nitrazine paper test); d) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); e) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). C125481 GAIA Terminology C C127945 GAIA Level 2 Assessment of Premature Preterm Rupture of Membranes GAIA Level 2 Assessment of Premature Preterm Rupture of Membranes is defined by four criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the three following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than; OR c) documentation of the membrane rupture by one of the following diagnostic tests: 1) Positive intra-amniotic dye-injection method; 2) Positive result on amniotic fluid alpha-fetoprotein test kit; 3) Amniotic fluid pH measurement (nitrazine paper test); 4) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); 5) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). Level 2 Assessment of Premature Preterm Rupture of Membranes Level 2 Assessment of Premature Preterm Rupture of Membranes is defined by four criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the three following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than; OR c) documentation of the membrane rupture by one of the following diagnostic tests: 1) Positive intra-amniotic dye-injection method; 2) Positive result on amniotic fluid alpha-fetoprotein test kit; 3) Amniotic fluid pH measurement (nitrazine paper test); 4) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); 5) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). C125481 GAIA Terminology C C127946 GAIA Level 3 Assessment of Premature Preterm Rupture of Membranes GAIA Level 3 Assessment of Premature Preterm Rupture of Membranes is defined by three criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of presumed amniotic fluid, which may be on vaginal speculum examination (pooling in the vagina), on inspection of the perineum (wet perineum due to leakage of fluid from the vagina), or fluid soaked cloth/clothes/sanitary pad. Level 3 Assessment of Premature Preterm Rupture of Membranes Level 3 Assessment of Premature Preterm Rupture of Membranes is defined by three criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of presumed amniotic fluid, which may be on vaginal speculum examination (pooling in the vagina), on inspection of the perineum (wet perineum due to leakage of fluid from the vagina), or fluid soaked cloth/clothes/sanitary pad. C125481 GAIA Terminology C C127947 GAIA Level 1 Assessment of Preterm Labor GAIA Level 1 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR transvaginal ultrasound during a two hour period; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. Level 1 Assessment of Preterm Labor Level 1 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR transvaginal ultrasound during a two hour period; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. C125481 GAIA Terminology C C127948 GAIA Level 2 Assessment of Preterm Labor GAIA Level 2 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR by clinical assessment; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. Level 2 Assessment of Preterm Labor Level 2 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR by clinical assessment; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. C125481 GAIA Terminology C C127949 GAIA Level 3 Assessment of Preterm Labor GAIA Level 3 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by clinical assessment; third, documented changes in cervical dilation or effacement during a two hour period. Level 3 Assessment of Preterm Labor Level 3 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by clinical assessment; third, documented changes in cervical dilation or effacement during a two hour period. C125481 GAIA Terminology C C127950 GAIA Level 1 Assessment of Provider Initiated Preterm Delivery GAIA Level 1 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, documentation in the healthcare record as noted by the delivering provider of the absence of any signs or symptoms of spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. Level 1 Assessment of Provider-Initiated Preterm Delivery Level 1 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, documentation in the healthcare record as noted by the delivering provider of the absence of any signs or symptoms of spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. C125481 GAIA Terminology C C127951 GAIA Level 2 Assessment of Provider Initiated Preterm Delivery GAIA Level 2 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, a report from the delivering provider, based on recall, that there were no signs or symptoms of the spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. Level 2 Assessment of Provider-Initiated Preterm Delivery Level 2 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, a report from the delivering provider, based on recall, that there were no signs or symptoms of the spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. C125481 GAIA Terminology C C127952 GAIA Level 3 Assessment of Provider Initiated Preterm Delivery GAIA Level 3 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, from recall, the patient reports that there were no signs or symptoms of spontaneous onset of preterm labor; third, from recall, the patient reports that the healthcare provider indicated the need to induce labor or to perform a cesarean delivery between, resulting in preterm delivery. Level 3 Assessment of Provider-Initiated Preterm Delivery Level 3 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, from recall, the patient reports that there were no signs or symptoms of spontaneous onset of preterm labor; third, from recall, the patient reports that the healthcare provider indicated the need to induce labor or to perform a cesarean delivery between, resulting in preterm delivery. C125481 GAIA Terminology C C127953 GAIA Level 1 Assessment of Insufficient Cervix GAIA Level 1 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must all be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or with preterm delivery; c) Less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by transvaginal ultrasound or digital examination. Level 1 Assessment of Insufficient Cervix Level 1 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must all be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or with preterm delivery; c) Less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by transvaginal ultrasound or digital examination. C125481 GAIA Terminology C C127954 GAIA Level 2 Assessment of Insufficient Cervix GAIA Level 2 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by digital examination. Level 2 Assessment of Insufficient Cervix Level 2 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by digital examination. C125481 GAIA Terminology C C127955 GAIA Level 3 Assessment of Insufficient Cervix GAIA Level 3 Assessment of Insufficient Cervix is defined by three criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, patient reported fetal delivery without painful contractions; third, the patient's history excludes other causes of mid-second trimester delivery. Level 3 Assessment of Insufficient Cervix Level 3 Assessment of Insufficient Cervix is defined by three criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, patient reported fetal delivery without painful contractions; third, the patient's history excludes other causes of mid-second trimester delivery. C125481 GAIA Terminology C C127957 GAIA Level 1 Major External Structural Defect GAIA Level 1 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician who is both experienced in diagnosing congenital anomalies and who has the highest level of morphology training for the specific setting. Level 1 Major External Structural Defect Level 1 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician who is both experienced in diagnosing congenital anomalies and who has the highest level of morphology training for the specific setting. C125481 GAIA Terminology C C127958 GAIA Level 2 Major External Structural Defect GAIA Level 2 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies. Level 2 Major External Structural Defect Level 2 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies. C125481 GAIA Terminology C C127959 GAIA Level 3 Major External Structural Defect GAIA Level 3 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a trained maternal or child health care provider with at least minimal experience diagnosing congenital anomalies; OR b) For live births, the diagnosis is confirmed using individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. Level 3 Major External Structural Defect Level 3 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a trained maternal or child health care provider with at least minimal experience diagnosing congenital anomalies; OR b) For live births, the diagnosis is confirmed using individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. C125481 GAIA Terminology C C127960 GAIA Level 4 Major External Structural Defect GAIA Level 4 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Confirmation by medical record review; OR b) Confirmed in claims data (ICD-9/ICD-10 diagnoses). Level 4 Major External Structural Defect Level 4 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Confirmation by medical record review; OR b) Confirmed in claims data (ICD-9/ICD-10 diagnoses). C125481 GAIA Terminology C C127961 GAIA Level 1 Major Internal Structural Defect GAIA Level 1 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require confirmation of the diagnosis by definitive imaging study or intraoperative diagnosis; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, alterations in the internal anatomy must be detected during an autopsy, which are subsequently confirmed by documentation by a pathologist or other relevant subspecialist. Level 1 Major Internal Structural Defect Level 1 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require confirmation of the diagnosis by definitive imaging study or intraoperative diagnosis; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, alterations in the internal anatomy must be detected during an autopsy, which are subsequently confirmed by documentation by a pathologist or other relevant subspecialist. C125481 GAIA Terminology C C127962 GAIA Level 2 Major Internal Structural Defect GAIA Level 2 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of morphology training for the specific setting without using definitive imaging or intraoperative evaluation; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, an internal structural defect is visible prenatally either by ultrasound or by other imaging modality. Level 2 Major Internal Structural Defect Level 2 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of morphology training for the specific setting without using definitive imaging or intraoperative evaluation; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, an internal structural defect is visible prenatally either by ultrasound or by other imaging modality. C125481 GAIA Terminology C C127963 GAIA Level 3 Major Internal Structural Defect GAIA Level 3 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, for a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and must either a) Require documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. Level 3 Major Internal Structural Defect Level 3 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, for a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and must either a) Require documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. C125481 GAIA Terminology C C127964 GAIA Level 4 Major Internal Structural Defect GAIA Level 4 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, at least one of the following requirements must be met: a) Alterations in the internal anatomy that are present at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired; OR b) Alterations in the internal anatomy that are present at the time of the stillbirth or of the spontaneous or therapeutic abortion; fourth, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or a child health care provider who has minimal experience diagnosing congenital anomalies; OR b) Confirmed by claims data (ICD-9/ICD-10 diagnoses). Level 4 Major Internal Structural Defect Level 4 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, at least one of the following requirements must be met: a) Alterations in the internal anatomy that are present at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired; OR b) Alterations in the internal anatomy that are present at the time of the stillbirth or of the spontaneous or therapeutic abortion; fourth, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or a child health care provider who has minimal experience diagnosing congenital anomalies; OR b) Confirmed by claims data (ICD-9/ICD-10 diagnoses). C125481 GAIA Terminology C C127965 GAIA Level 1 Major Functional Defect GAIA Level 1 Major Functional Defect is defined by two criteria. first, at least one of the following requirements must be met: a) For live births, there must be alterations in functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be confirmation of the defect(s) by definitive diagnostic study. Level 1 Major Functional Defect Level 1 Major Functional Defect is defined by two criteria. first, at least one of the following requirements must be met: a) For live births, there must be alterations in functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be confirmation of the defect(s) by definitive diagnostic study. C125481 GAIA Terminology C C127966 GAIA Level 2 Major Functional Defect GAIA Level 2 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of training in the diagnosis of functional defects for the specific setting. Level 2 Major Functional Defect Level 2 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of training in the diagnosis of functional defects for the specific setting. C125481 GAIA Terminology C C127967 GAIA Level 3 Major Functional Defect GAIA Level 3 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a clinician who has some experience diagnosing functional defects; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. Level 3 Major Functional Defect Level 3 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a clinician who has some experience diagnosing functional defects; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. C125481 GAIA Terminology C C127968 GAIA Level 4 Major Functional Defect GAIA Level 4 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or child health care provider who is not a qualified geneticist, neonatologist, pathologist, subspecialist, paediatrician, obstetrician, or family medicine practitioner; OR b) Confirmation by claims data (ICD-9/ICD-10 diagnoses). Level 4 Major Functional Defect Level 4 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or child health care provider who is not a qualified geneticist, neonatologist, pathologist, subspecialist, paediatrician, obstetrician, or family medicine practitioner; OR b) Confirmation by claims data (ICD-9/ICD-10 diagnoses). C125481 GAIA Terminology C C127969 GAIA Level 1 Neonatal Death in a Non-viable Live Birth GAIA Level 1 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (a GA level of certainty of one); OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in a Non-viable Live Birth Level 1 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (a GA level of certainty of one); OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127970 GAIA Level 2 Neonatal Death in a Non-viable Live Birth GAIA Level 2 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in a Non-viable Live Birth Level 2 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127971 GAIA Level 3 Neonatal Death in a Non-viable Live Birth GAIA Level 3 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be less than 5 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in a Non-viable Live Birth Level 3 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be less than 5 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127972 GAIA Level 1 Neonatal Death in an Extremely Preterm Live Birth GAIA Level 1 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 weeks and less than 28 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 500g but less than 1000g. Third, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in an Extremely Preterm Live Birth Level 1 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 weeks and less than 28 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 500g but less than 1000g. Third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127973 GAIA Level 2 Neonatal Death in an Extremely Preterm Live Birth GAIA Level 2 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 and less than 28 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 500g but less than 1000g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in an Extremely Preterm Live Birth Level 2 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 and less than 28 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 500g but less than 1000g; third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127974 GAIA Level 3 Neonatal Death in an Extremely Preterm Live Birth GAIA Level 3 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 5 months but less than 7 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in an Extremely Preterm Live Birth Level 3 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 5 months but less than 7 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127975 GAIA Level 1 Neonatal Death in a Preterm Live Birth GAIA Level 1 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 weeks and less than 37 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in a Preterm Live Birth Level 1 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 weeks and less than 37 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127976 GAIA Level 2 Neonatal Death in a Preterm Live Birth GAIA Level 2 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 and less than 37 weeks (where the GA level of certainty is either level one or level two); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in a Preterm Live Birth Level 2 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 and less than 37 weeks (where the GA level of certainty is either level one or level two); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127977 GAIA Level 3 Neonatal Death in a Preterm Live Birth GAIA Level 3 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 7 months but less than 9 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in a Preterm Live Birth Level 3 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 7 months but less than 9 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127978 GAIA Level 1 Neonatal Death in a Term Live Birth GAIA Level 1 Neonatal Death in a Term Live Birth is defined by four criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 37 weeks (a GA level of certainty of one); third, at least one of the following requirements must be met: a) Birth weight greater than 2500g; OR b) Documented intra-uterine growth retardation if weight is less than or equal to 2500g; fourth, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in a Term Live Birth Level 1 Neonatal Death in a Term Live Birth is defined by four criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 37 weeks (a GA level of certainty of one); third, at least one of the following requirements must be met: a) Birth weight greater than 2500g; OR b) Documented intra-uterine growth retardation if weight is less than or equal to 2500g; fourth, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127979 GAIA Level 2 Neonatal Death in a Term Live Birth GAIA Level 2 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 37 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 2500g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in a Term Live Birth Level 2 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 37 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 2500g; third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127980 GAIA Level 3 Neonatal Death in a Term Live Birth GAIA Level 3 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 9 months according to parent/ family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in a Term Live Birth Level 3 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 9 months according to parent/ family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C125481 GAIA Terminology C C127981 GAIA Level 1 Maternal Immunization GAIA Level 1 Maternal immunization is defined by three criteria: first, the pregnancy must be confirmed by either a positive pregnancy test or by ultrasound confirmation; second, the date/time of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the details of vaccine must include the lot number and the date of immunization. Level 1 Maternal Immunisation Level 1 Maternal immunization is defined by three criteria: first, the pregnancy must be confirmed by either a positive pregnancy test or by ultrasound confirmation; second, the date/time of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the details of vaccine must include the lot number and the date of immunization. C125481 GAIA Terminology C C127982 GAIA Level 2 Maternal Immunization GAIA Level 2 Maternal immunization is defined by three criteria: first, pregnancy must be confirmed by both the patient's report of cessation of menstrual period and by physical exam revealing a gravid uterus; second, the date (at least month and year) of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the medical record must contain details of the disease against which the individual was vaccinated. Level 2 Maternal Immunisation Level 2 Maternal immunization is defined by three criteria: first, pregnancy must be confirmed by both the patient's report of cessation of menstrual period and by physical exam revealing a gravid uterus; second, the date (at least month and year) of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the medical record must contain details of the disease against which the individual was vaccinated. C125481 GAIA Terminology C C127983 GAIA Level 3 Maternal Immunization GAIA Level 3 Maternal immunization is defined by two criteria: first, the woman/medical attendant reports the pregnancy; second, the woman reports receipt of vaccination during pregnancy, but no formal recording of the immunization is available. Level 3 Maternal Immunisation Level 3 Maternal immunization is defined by two criteria: first, the woman/medical attendant reports the pregnancy; second, the woman reports receipt of vaccination during pregnancy, but no formal recording of the immunization is available. C125481 GAIA Terminology C C127984 GAIA Level 1 Neonatal Invasive Bloodstream Infection GAIA Level 1 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, identification of a recognized pathogen from a normally sterile site using a validated method; second, if a normally non-pathogenic organism is isolated from blood cultures the following two requirements must be met: a) The cultures must be obtained from two different sites OR taken at two different times; b) One or more of the level 2 criteria must be present. Level 1 Neonatal Blood Stream Infection Level 1 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, identification of a recognized pathogen from a normally sterile site using a validated method; second, if a normally non-pathogenic organism is isolated from blood cultures the following two requirements must be met: a) The cultures must be obtained from two different sites OR taken at two different times; b) One or more of the level 2 criteria must be present. C125481 GAIA Terminology C C127985 GAIA Level 2 Neonatal Invasive Bloodstream Infection GAIA Level 2 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 diagnostic certainty; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachycardia or new or more frequent episodes of bradycardia; c) New or more frequent episodes of apnea or increased oxygen requirement or increased requirement for ventilatory support; d) Lethargy or moving only when stimulated or hypotonia or irritability; e) Difficulty in feeding or abdominal distention; f) Pallor or poor perfusion or hypotension; g) Abnormal white cell count or I/T (immature/total neutrophil) ratio greater than 0.2; h) Abnormal platelet count; i) Increased number of inflammatory markers (CRP, procalcitonin); j) Metabolic acidosis as defined by a base excess. Level 2 Neonatal Blood Stream Infection Level 2 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 diagnostic certainty; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachycardia or new or more frequent episodes of bradycardia; c) New or more frequent episodes of apnea or increased oxygen requirement or increased requirement for ventilatory support; d) Lethargy or moving only when stimulated or hypotonia or irritability; e) Difficulty in feeding or abdominal distention; f) Pallor or poor perfusion or hypotension; g) Abnormal white cell count or I/T (immature/total neutrophil) ratio greater than 0.2; h) Abnormal platelet count; i) Increased number of inflammatory markers (CRP, procalcitonin); j) Metabolic acidosis as defined by a base excess. C125481 GAIA Terminology C C127986 GAIA Level 3 Neonatal Invasive Bloodstream Infection GAIA Level 3 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 or 2 diagnostic certainty; second, two or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or severe chest indrawing or grunting or cyanosis; c) Change in level of activity; d) History of feeding difficulty; e) History of convulsions. Level 3 Neonatal Blood Stream Infection Level 3 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 or 2 diagnostic certainty; second, two or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or severe chest indrawing or grunting or cyanosis; c) Change in level of activity; d) History of feeding difficulty; e) History of convulsions. C125481 GAIA Terminology C C127987 GAIA Level 1 Neonatal Infectious Meningitis GAIA Level 1 Neonatal Infectious Meningitis is defined by two criteria: first, the recognized pathogen must be identified, using a validated method, from cerebrospinal fluid (CSF); second, if an organism normally considered to be non-pathogenic is identified from the CSF, level 1 of diagnostic certainty additionally requires all level 2 criteria: i.e. CSF pleocytosis AND temperature criteria AND one or more clinical criteria. Level 1 Neonatal Meningitis Level 1 Neonatal Infectious Meningitis is defined by two criteria: first, the recognized pathogen must be identified, using a validated method, from cerebrospinal fluid (CSF); second, if an organism normally considered to be non-pathogenic is identified from the CSF, level 1 of diagnostic certainty additionally requires all level 2 criteria: i.e. CSF pleocytosis AND temperature criteria AND one or more clinical criteria. C125481 GAIA Terminology C C127988 GAIA Level 2 Neonatal Infectious Meningitis GAIA Level 2 Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis OR positive IgM antibodies to a specific pathogen in the CSF; second, a recognized pathogen is identified, using a validated method from a normally sterile site other than the CSF; third, a temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, one or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. Level 2 Neonatal Meningitis Level 2 Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis OR positive IgM antibodies to a specific pathogen in the CSF; second, a recognized pathogen is identified, using a validated method from a normally sterile site other than the CSF; third, a temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, one or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. C125481 GAIA Terminology C C127989 GAIA Level 3a Neonatal Infectious Meningitis GAIA Level 3a Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis; second, NO recognized pathogen is identified, using a validated method, from a normally sterile site; third, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, three or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. Level 3a Neonatal Bacterial/Fungal/Viral Meningitis Level 3a Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis; second, NO recognized pathogen is identified, using a validated method, from a normally sterile site; third, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, three or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. C125481 GAIA Terminology C C127990 GAIA Level 3b Neonatal Infectious Meningitis GAIA Level 3b Neonatal Infectious Meningitis is defined by three criteria: first, no lumbar puncture is done or no sample is available; second, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; third, four or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. Level 3b Neonatal Meningitis Level 3b Neonatal Infectious Meningitis is defined by three criteria: first, no lumbar puncture is done or no sample is available; second, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; third, four or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. C125481 GAIA Terminology C C127991 GAIA Level 1 Neonatal Respiratory Tract Infection GAIA Level 1 Neonatal Respiratory Tract Infection is defined by two criteria: first, a new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray OR a recognized virus identified using a validated assay from an upper respiratory sample OR a recognized pathogen identified, using a validated method, from a normally sterile site; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. Level 1 Neonatal Respiratory Tract Infection Level 1 Neonatal Respiratory Tract Infection is defined by two criteria: first, a new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray OR a recognized virus identified using a validated assay from an upper respiratory sample OR a recognized pathogen identified, using a validated method, from a normally sterile site; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. C125481 GAIA Terminology C C127992 GAIA Level 2 Neonatal Respiratory Tract Infection GAIA Level 2 Neonatal Respiratory Tract Infection is defined by two criteria:first, new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray; second, four or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. Level 2 Neonatal Respiratory Tract Infection Level 2 Neonatal Respiratory Tract Infection is defined by two criteria:first, new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray; second, four or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. C125481 GAIA Terminology C C127994 GAIA Level 1 Non-reassuring Fetal Status GAIA Level 1 Non-reassuring Fetal Status is defined by two criteria: first, a Category III fetal heart rate tracing detected via continuous cardiotocography as defined by the NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern; third, umbilical cord blood analysis that is consistent with metabolic acidosis (pH less than 7.0 and a base deficit greater than 12mmol/L). Level 1 Non-reassuring Fetal Status Level 1 Non-reassuring Fetal Status is defined by two criteria: first, a Category III fetal heart rate tracing detected via continuous cardiotocography as defined by the NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern; third, umbilical cord blood analysis that is consistent with metabolic acidosis (pH less than 7.0 and a base deficit greater than 12mmol/L). C125481 GAIA Terminology C C127995 GAIA Level 2 Non-reassuring Fetal Status GAIA Level 2 Non-reassuring Fetal Status is defined by the presence of at least one of the following two criteria: first, a category III fetal heart rate tracing detected via continuous cardiotocography as defined by NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern. Level 2 Non-reassuring Fetal Status Level 2 Non-reassuring Fetal Status is defined by the presence of at least one of the following two criteria: first, a category III fetal heart rate tracing detected via continuous cardiotocography as defined by NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern. C125481 GAIA Terminology C C127997 GAIA Level 1 Maternal Death GAIA Level 1 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy as established by any one of the following documented requirements: a) Ultrasound examination; b) Fetal heart tones; c) Positive serum or urine human chorionic gonadotropin pregnancy test; d) Delivery of a neonate or other products of conception (abortus, stillborn); second, the death of the mother while pregnant or within 42 days of the termination of a pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death as one of the following: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental. Level 1 Maternal Death Level 1 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy as established by any one of the following documented requirements: a) Ultrasound examination; b) Fetal heart tones; c) Positive serum or urine human chorionic gonadotropin pregnancy test; d) Delivery of a neonate or other products of conception (abortus, stillborn); second, the death of the mother while pregnant or within 42 days of the termination of a pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death as one of the following: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental. C125481 GAIA Terminology C C127998 GAIA Level 2 Maternal Death GAIA Level 2 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy, in the absence of level 1 criteria, as established by either of the following requirements: a) last menstrual period date; b) Serial symphysio fundal height examinations; second, death of the mother while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. Level 2 Maternal Death Level 2 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy, in the absence of level 1 criteria, as established by either of the following requirements: a) last menstrual period date; b) Serial symphysio fundal height examinations; second, death of the mother while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. C125481 GAIA Terminology C C127999 GAIA Level 3 Maternal Death GAIA Level 3 Maternal Death is defined by three criteria: first, the absence of level 1 or level 2 criteria for establishing diagnosis of pregnancy, and both the uncertainty of the individual's last menstrual period date and no documented clinical examination; second, death of the mother temporal to pregnancy, childbirth, or the postpartum period when exact timing of death is unknown; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non-obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. Level 3 Maternal Death Level 3 Maternal Death is defined by three criteria: first, the absence of level 1 or level 2 criteria for establishing diagnosis of pregnancy, and both the uncertainty of the individual's last menstrual period date and no documented clinical examination; second, death of the mother temporal to pregnancy, childbirth, or the postpartum period when exact timing of death is unknown; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non-obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. C125481 GAIA Terminology C C128000 GAIA Level 1 Postpartum Hemorrhage GAIA Level 1 Postpartum Hemorrhage is the presence of genital bleeding after delivery, leading to severe maternal outcome (maternal death or maternal near miss) as defined by WHO. Level 1 Postpartum Haemorrhage Level 1 Postpartum Hemorrhage is the presence of genital bleeding after delivery, leading to severe maternal outcome (maternal death or maternal near miss) as defined by WHO. C125481 GAIA Terminology C C128001 GAIA Level 2 Postpartum Hemorrhage GAIA Level 2 Postpartum Hemorrhage is defined by the presence of the following criteria: genital bleeding after delivery with at least one of the following: a) Measured abnormal bleeding (1000ml or more); or b) Any bleeding leading to hypotension or blood transfusion. Level 2 Postpartum Haemorrhage Level 2 Postpartum Hemorrhage is defined by the presence of the following criteria: genital bleeding after delivery with at least one of the following: a) Measured abnormal bleeding (1000ml or more); or b) Any bleeding leading to hypotension or blood transfusion. C125481 GAIA Terminology C C128002 GAIA Level 3 Postpartum Hemorrhage GAIA Level 3 Postpartum Hemorrhage is defined by the presence of genital bleeding after delivery that is estimated at 1000ml or more. Level 3 Postpartum Haemorrhage Level 3 Postpartum Hemorrhage is defined by the presence of genital bleeding after delivery that is estimated at 1000ml or more. C125481 GAIA Terminology C C128003 GAIA Level 1 Preeclampsia GAIA Level 1 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level one diagnostic certainty (proteinuria diagnosed with greater than or equal to 300 mg of protein during 24 hour urine collection OR greater than or equal to 0.3 for spot protein:creatinine ratio.) Level 1 Preeclampsia Level 1 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level one diagnostic certainty (proteinuria diagnosed with greater than or equal to 300 mg of protein during 24 hour urine collection OR greater than or equal to 0.3 for spot protein:creatinine ratio.) C125481 GAIA Terminology C C128004 GAIA Level 2 Preeclampsia GAIA Level 2 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level 2 diagnostic certainty (proteinuria diagnosed with greater than or equal to 1+ protein on urine dipstick). Level 2 Preeclampsia Level 2 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level 2 diagnostic certainty (proteinuria diagnosed with greater than or equal to 1+ protein on urine dipstick). C125481 GAIA Terminology C C128006 GAIA Level 1 Preeclampsia with Severe Features GAIA Level 1 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour); third, the presence of one or more of the following requirements: a) Systolic blood pressure greater than or equal to 160mmHg and/or diastolic blood pressure greater than or equal to 110mmHg, which is confirmed after only minutes; b) Development of severe, persistent headache; c) Development of visual changes; d) Eclampsia; e) New onset thrombocytopenia (platelets less than 100,000/microliter); f) New onset unremitting epigastric pain; g) AST and ALT elevated to twice the upper limit of normal; h) Evidence of liver capsular hematoma or liver rupture (diagnosed on clinical exam or with imaging); i) Worsening renal function, as evidenced by serum creatinine level greater than 1.1 mg/dL, a doubling of the serum creatinine (absent other renal disease), or oliguria (less than 500 cc/24 hours); j) Pulmonary edema (confirmed on either imaging with chest x-ray or on clinical exam). Level 1 Preeclampsia with Severe Features Level 1 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour); third, the presence of one or more of the following requirements: a) Systolic blood pressure greater than or equal to 160mmHg and/or diastolic blood pressure greater than or equal to 110mmHg, which is confirmed after only minutes; b) Development of severe, persistent headache; c) Development of visual changes; d) Eclampsia; e) New onset thrombocytopenia (platelets less than 100,000/microliter); f) New onset unremitting epigastric pain; g) AST and ALT elevated to twice the upper limit of normal; h) Evidence of liver capsular hematoma or liver rupture (diagnosed on clinical exam or with imaging); i) Worsening renal function, as evidenced by serum creatinine level greater than 1.1 mg/dL, a doubling of the serum creatinine (absent other renal disease), or oliguria (less than 500 cc/24 hours); j) Pulmonary edema (confirmed on either imaging with chest x-ray or on clinical exam). C125481 GAIA Terminology C C128007 GAIA Level 2 Preeclampsia with Severe Features GAIA Level 2 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the diagnosis of new onset nausea and vomiting. Level 2 Preeclampsia with Severe Features Level 2 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the diagnosis of new onset nausea and vomiting. C125481 GAIA Terminology C C128008 GAIA Insufficient Evidence Preeclampsia with Severe Features GAIA Preeclampsia with Severe Features with Insufficient Evidence is a pregnancy with a gestational age greater than or equal to 20 weeks and the inability to measure blood pressure. Insufficient Evidence Preeclampsia with Severe Features Preeclampsia with Severe Features with Insufficient Evidence is a pregnancy with a gestational age greater than or equal to 20 weeks and the inability to measure blood pressure. C125481 GAIA Terminology C C128009 GAIA Level 1 Gestational Hypertension GAIA Level 1 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by 24 hour urine collection less than 300 mg, and spot protein:creatinine ratio less than 0.3). Level 1 Gestational Hypertension Level 1 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by 24 hour urine collection less than 300 mg, and spot protein:creatinine ratio less than 0.3). C125481 GAIA Terminology C C128010 GAIA Level 2 Gestational Hypertension GAIA Level 2 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by urine dipstick result of negative or trace). Level 2 Gestational Hypertension Level 2 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by urine dipstick result of negative or trace). C125481 GAIA Terminology C C128011 GAIA Gestational Hypertension with Insufficient Evidence GAIA Gestational Hypertension with Insufficient Evidence is defined by two criteria: first, a pregnancy with gestational age greater than or equal to 20 weeks; second, one or more of the following requirements: a) The inability to measure blood pressure; b) The inability to evaluate for proteinuria. Gestational Hypertension with Insufficient Evidence GAIA Gestational Hypertension with Insufficient Evidence is defined by two criteria: first, a pregnancy with gestational age greater than or equal to 20 weeks; second, one or more of the following requirements: a) The inability to measure blood pressure; b) The inability to evaluate for proteinuria. C125481 GAIA Terminology C C128014 GAIA Level 2A Assessment of Gestational Age GAIA Level 2A Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Certain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks), (If LMP and ultrasound (U/S) do not correlate, default to U/S GA assessment); OR b) Certain LMP date with first trimester physical examination. Level 2A Assessment of Prematurity and Gestational Age Level 2A Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Certain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks), (If LMP and ultrasound (U/S) do not correlate, default to U/S GA assessment); OR b) Certain LMP date with first trimester physical examination. C125481 GAIA Terminology C C128015 GAIA Level 2B Assessment of Gestational Age GAIA Level 2B Assessment of Gestational Age is defined by the following criteria: uncertain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks). Level 2B Assessment of Prematurity and Gestational Age Level 2B Assessment of Gestational Age is defined by the following criteria: uncertain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks). C125481 GAIA Terminology C C128016 GAIA Level 3A Assessment of Gestational Age GAIA Level 3A Assessment of Gestational Age is defined by the presence at least one of the following criteria: a) Certain last menstrual period (LMP) date with third trimester scan (28 0/7 weeks or more); OR b) Certain LMP date with confirmatory second trimester fundal height (FH); OR c) Certain LMP date with birth weight; OR d) Uncertain LMP date with first trimester physical examination. Level 3A Assessment of Prematurity and Gestational Age Level 3A Assessment of Gestational Age is defined by the presence at least one of the following criteria: a) Certain last menstrual period (LMP) date with third trimester scan (28 0/7 weeks or more); OR b) Certain LMP date with confirmatory second trimester fundal height (FH); OR c) Certain LMP date with birth weight; OR d) Uncertain LMP date with first trimester physical examination. C125481 GAIA Terminology C C128017 GAIA Level 3B Assessment of Gestational Age GAIA Level 3B Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Uncertain last menstrual period (LMP) date with fundal height (FH); OR b) Uncertain LMP date with newborn physical assessment; OR c) Uncertain LMP date with birth weight. Level 3B Assessment of Prematurity and Gestational Age Level 3B Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Uncertain last menstrual period (LMP) date with fundal height (FH); OR b) Uncertain LMP date with newborn physical assessment; OR c) Uncertain LMP date with birth weight. C125481 GAIA Terminology C C128018 GAIA Level 1 Antepartum Stillbirth GAIA Level 1 Antepartum Stillbirth is defined by four criteria: first, one or more of the following three requirements must be met: a) Prenatal ultrasound examination (e.g. basic ultrasound or special ultrasound with Doppler) documenting an absence of fetal cardiac activity or movement before the onset of labor; b) Radiology findings consistent with intrauterine fetal death; c) Delivery of an infant with no of signs of life at birth, including no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and Apgar scores of 0 at both 1 and 5 minutes. The determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, the following three criteria must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) OR non-electronic devices (e.g. stethoscope, fetoscope, or Pinard horn) that documents the absence of a fetal heartbeat; third, one of the following two requirements must be met: a) Attended delivery, followed by a post-delivery physical examination of the fetus by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with antepartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, nurse practitioner, a physician's assistant, or other qualified trained practitioner); OR b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1 in GA assessment algorithm). Level 1 Antepartum Stillbirth Level 1 Antepartum Stillbirth is defined by four criteria: first, one or more of the following three requirements must be met: a) Prenatal ultrasound examination (e.g. basic ultrasound or special ultrasound with Doppler) documenting an absence of fetal cardiac activity or movement before the onset of labor; b) Radiology findings consistent with intrauterine fetal death; c) Delivery of an infant with no of signs of life at birth, including no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and Apgar scores of 0 at both 1 and 5 minutes. The determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, the following three criteria must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) OR non-electronic devices (e.g. stethoscope, fetoscope, or Pinard horn) that documents the absence of a fetal heartbeat; third, one of the following two requirements must be met: a) Attended delivery, followed by a post-delivery physical examination of the fetus by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with antepartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, nurse practitioner, a physician's assistant, or other qualified trained practitioner); OR b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1 in GA assessment algorithm). C125481 GAIA Terminology C C128019 GAIA Level 2 Antepartum Stillbirth GAIA Level 2 Antepartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; third, one or more of the following two requirements must be met: a) Attended delivery followed by a post-delivery physical examination of the fetus that is performed by specialist or qualified trained practitioner appropriate to the health care setting, and that is consistent with antepartum death; b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). Level 2 Antepartum Stillbirth Level 2 Antepartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; third, one or more of the following two requirements must be met: a) Attended delivery followed by a post-delivery physical examination of the fetus that is performed by specialist or qualified trained practitioner appropriate to the health care setting, and that is consistent with antepartum death; b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). C125481 GAIA Terminology C C128020 GAIA Level 3 Antepartum Stillbirth GAIA Level 3 Antepartum Stillbirth is defined by three criteria: first, delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more prior to delivery; b) Report of auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; c) Non-attended delivery followed by a post-delivery physical examination of the fetus that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with antepartum death; d) a verbal history provided by a trained health care provider, non-medical witness, or the mother of the fetus documenting that the fetus was born with no signs of life, was unresponsive to resuscitation efforts immediately after delivery, and had physical features consistent with antepartum death; third, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters. Level 3 Antepartum Stillbirth Level 3 Antepartum Stillbirth is defined by three criteria: first, delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more prior to delivery; b) Report of auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; c) Non-attended delivery followed by a post-delivery physical examination of the fetus that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with antepartum death; d) a verbal history provided by a trained health care provider, non-medical witness, or the mother of the fetus documenting that the fetus was born with no signs of life, was unresponsive to resuscitation efforts immediately after delivery, and had physical features consistent with antepartum death; third, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters. C125481 GAIA Terminology C C128021 GAIA Level 4 Antepartum Stillbirth GAIA Level 4 Antepartum Stillbirth is defined by two criteria: first, a report of a stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. Level 4 Antepartum Stillbirth Level 4 Antepartum Stillbirth is defined by two criteria: first, a report of a stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. C125481 GAIA Terminology C C128022 GAIA Level 1 Intrapartum Stillbirth GAIA Level 1 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, evidence of a live fetus prior to the onset of labor (confirmed by documentation of fetal movement and of fetal heart tones by ultrasound prior to onset of labor). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with intrapartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, or other qualified trained practitioner); fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal-neonatal parameters (level 1 in GA assessment algorithm). Level 1 Intrapartum Stillbirth Level 1 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, evidence of a live fetus prior to the onset of labor (confirmed by documentation of fetal movement and of fetal heart tones by ultrasound prior to onset of labor). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with intrapartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, or other qualified trained practitioner); fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal-neonatal parameters (level 1 in GA assessment algorithm). C125481 GAIA Terminology C C128023 GAIA Level 2 Intrapartum Stillbirth GAIA Level 2 Intrapartum Stillbirth is defined by four criteria: first, the delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry OR documentation of lack of response to resuscitation efforts; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor and documentation of fetal heart tones by auscultation or hand held Doppler). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and which is consistent with intrapartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). Level 2 Intrapartum Stillbirth Level 2 Intrapartum Stillbirth is defined by four criteria: first, the delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry OR documentation of lack of response to resuscitation efforts; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor and documentation of fetal heart tones by auscultation or hand held Doppler). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and which is consistent with intrapartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). C125481 GAIA Terminology C C128024 GAIA Level 3 Intrapartum Stillbirth GAIA Level 3 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant who is reported to have no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor OR auscultation of fetal heart tones). NOTE: in the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, a non-attended delivery followed by a post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with intrapartum death, or a verbal history that is provided by a trained health care provider, a non-medical witness, or the mother of the fetus that documents a fetus born with no signs of life and who was unresponsive to resuscitation efforts immediately after birth; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 2-3 in GA assessment algorithm). Level 3 Intrapartum Stillbirth Level 3 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant who is reported to have no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor OR auscultation of fetal heart tones). NOTE: in the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, a non-attended delivery followed by a post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with intrapartum death, or a verbal history that is provided by a trained health care provider, a non-medical witness, or the mother of the fetus that documents a fetus born with no signs of life and who was unresponsive to resuscitation efforts immediately after birth; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 2-3 in GA assessment algorithm). C125481 GAIA Terminology C C128025 GAIA Level 4 Intrapartum Stillbirth GAIA Level 4 Intrapartum Stillbirth is defined by two criteria: first, a report of stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. Level 4 Intrapartum Stillbirth Level 4 Intrapartum Stillbirth is defined by two criteria: first, a report of stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. C125481 GAIA Terminology C C127957 GAIA Level 1 Major External Structural Defect GAIA Level 1 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician who is both experienced in diagnosing congenital anomalies and who has the highest level of morphology training for the specific setting. Level 1 Major External Structural Defect Level 1 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician who is both experienced in diagnosing congenital anomalies and who has the highest level of morphology training for the specific setting. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127958 GAIA Level 2 Major External Structural Defect GAIA Level 2 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies. Level 2 Major External Structural Defect Level 2 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, there must be documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127959 GAIA Level 3 Major External Structural Defect GAIA Level 3 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a trained maternal or child health care provider with at least minimal experience diagnosing congenital anomalies; OR b) For live births, the diagnosis is confirmed using individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. Level 3 Major External Structural Defect Level 3 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a trained maternal or child health care provider with at least minimal experience diagnosing congenital anomalies; OR b) For live births, the diagnosis is confirmed using individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127960 GAIA Level 4 Major External Structural Defect GAIA Level 4 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Confirmation by medical record review; OR b) Confirmed in claims data (ICD-9/ICD-10 diagnoses). Level 4 Major External Structural Defect Level 4 Major External Structural Defect is defined by four criteria: first, the defects are of a prenatal origin; second, at least one of the following requirements must be met: a) Alterations in the external anatomy that are present and visible at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired OR b) Alterations in the external anatomy that are present and visible in a stillbirth or in the products of conception of a spontaneous or therapeutic abortion; third, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; fourth, at least one of the following requirements must be met: a) Confirmation by medical record review; OR b) Confirmed in claims data (ICD-9/ICD-10 diagnoses). C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127961 GAIA Level 1 Major Internal Structural Defect GAIA Level 1 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require confirmation of the diagnosis by definitive imaging study or intraoperative diagnosis; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, alterations in the internal anatomy must be detected during an autopsy, which are subsequently confirmed by documentation by a pathologist or other relevant subspecialist. Level 1 Major Internal Structural Defect Level 1 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require confirmation of the diagnosis by definitive imaging study or intraoperative diagnosis; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, alterations in the internal anatomy must be detected during an autopsy, which are subsequently confirmed by documentation by a pathologist or other relevant subspecialist. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127962 GAIA Level 2 Major Internal Structural Defect GAIA Level 2 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of morphology training for the specific setting without using definitive imaging or intraoperative evaluation; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, an internal structural defect is visible prenatally either by ultrasound or by other imaging modality. Level 2 Major Internal Structural Defect Level 2 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, one of the following requirements must be met: a) For a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and require documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of morphology training for the specific setting without using definitive imaging or intraoperative evaluation; OR b) For a stillbirth, or for a spontaneous or therapeutic abortion, an internal structural defect is visible prenatally either by ultrasound or by other imaging modality. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127963 GAIA Level 3 Major Internal Structural Defect GAIA Level 3 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, for a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and must either a) Require documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. Level 3 Major Internal Structural Defect Level 3 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, for a live birth, alterations in the internal anatomy must be present at the time of live birth, must persist beyond the immediate peripartum period unless surgically repaired, and must either a) Require documented confirmation of a diagnosis made by a clinician with some experience diagnosing congenital anomalies; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127964 GAIA Level 4 Major Internal Structural Defect GAIA Level 4 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, at least one of the following requirements must be met: a) Alterations in the internal anatomy that are present at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired; OR b) Alterations in the internal anatomy that are present at the time of the stillbirth or of the spontaneous or therapeutic abortion; fourth, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or a child health care provider who has minimal experience diagnosing congenital anomalies; OR b) Confirmed by claims data (ICD-9/ICD-10 diagnoses). Level 4 Major Internal Structural Defect Level 4 Major Internal Structural Defect is defined by three criteria: first, the defects are prenatal in origin; second, the defect(s) affect (or have the propensity to affect) the health, survival, or physical or cognitive functioning of the individual; third, at least one of the following requirements must be met: a) Alterations in the internal anatomy that are present at the time of live birth, and that persist beyond the immediate peripartum period unless surgically repaired; OR b) Alterations in the internal anatomy that are present at the time of the stillbirth or of the spontaneous or therapeutic abortion; fourth, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or a child health care provider who has minimal experience diagnosing congenital anomalies; OR b) Confirmed by claims data (ICD-9/ICD-10 diagnoses). C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127965 GAIA Level 1 Major Functional Defect GAIA Level 1 Major Functional Defect is defined by two criteria. first, at least one of the following requirements must be met: a) For live births, there must be alterations in functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be confirmation of the defect(s) by definitive diagnostic study. Level 1 Major Functional Defect Level 1 Major Functional Defect is defined by two criteria. first, at least one of the following requirements must be met: a) For live births, there must be alterations in functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be confirmation of the defect(s) by definitive diagnostic study. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127966 GAIA Level 2 Major Functional Defect GAIA Level 2 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of training in the diagnosis of functional defects for the specific setting. Level 2 Major Functional Defect Level 2 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or for spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, there must be documented confirmation of a diagnosis made by a clinician who is experienced in diagnosing congenital anomalies, and who has the highest level of training in the diagnosis of functional defects for the specific setting. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127967 GAIA Level 3 Major Functional Defect GAIA Level 3 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a clinician who has some experience diagnosing functional defects; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. Level 3 Major Functional Defect Level 3 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation of a diagnosis made by a clinician who has some experience diagnosing functional defects; OR b) Confirmation of a diagnosis using either individual (ICD-9/ICD-10) codes or as part of an ICD-9/ICD-10 code based algorithm, for which the outcome (individual code or algorithm) has been validated. C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127968 GAIA Level 4 Major Functional Defect GAIA Level 4 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or child health care provider who is not a qualified geneticist, neonatologist, pathologist, subspecialist, paediatrician, obstetrician, or family medicine practitioner; OR b) Confirmation by claims data (ICD-9/ICD-10 diagnoses). Level 4 Major Functional Defect Level 4 Major Functional Defect is defined by two criteria: first, at least one of the following requirements must be met: a) For live births, there must be alterations in the functioning of one or more organs or body parts that are not due to a structural defect, that are present at the time of live birth (or propensity to develop alteration present at live birth), and that persist beyond the immediate peripartum period, unless treated through gene therapy or stem cell transplantation; OR b) For stillbirths or spontaneous or therapeutic abortions, there must be alterations in the function of one or more organs or body parts that are not due to a structural defect; second, at least one of the following requirements must be met: a) Documented confirmation in the medical record that the anomaly was present at the time of live birth or at the time of fetal demise, and that the anomaly was diagnosed by a trained maternal or child health care provider who is not a qualified geneticist, neonatologist, pathologist, subspecialist, paediatrician, obstetrician, or family medicine practitioner; OR b) Confirmation by claims data (ICD-9/ICD-10 diagnoses). C126852 GAIA Major Congenital Anomalies Level of Diagnostic Certainty Terminology C C127969 GAIA Level 1 Neonatal Death in a Non-viable Live Birth GAIA Level 1 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (a GA level of certainty of one); OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in a Non-viable Live Birth Level 1 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (a GA level of certainty of one); OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127970 GAIA Level 2 Neonatal Death in a Non-viable Live Birth GAIA Level 2 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in a Non-viable Live Birth Level 2 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age less than 22 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight less than 500g; third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127971 GAIA Level 3 Neonatal Death in a Non-viable Live Birth GAIA Level 3 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be less than 5 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in a Non-viable Live Birth Level 3 Neonatal Death in a Non-viable Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be less than 5 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127972 GAIA Level 1 Neonatal Death in an Extremely Preterm Live Birth GAIA Level 1 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 weeks and less than 28 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 500g but less than 1000g. Third, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in an Extremely Preterm Live Birth Level 1 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 weeks and less than 28 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 500g but less than 1000g. Third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127973 GAIA Level 2 Neonatal Death in an Extremely Preterm Live Birth GAIA Level 2 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 and less than 28 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 500g but less than 1000g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in an Extremely Preterm Live Birth Level 2 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 22 and less than 28 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 500g but less than 1000g; third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127974 GAIA Level 3 Neonatal Death in an Extremely Preterm Live Birth GAIA Level 3 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 5 months but less than 7 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in an Extremely Preterm Live Birth Level 3 Neonatal Death in an Extremely Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 5 months but less than 7 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127975 GAIA Level 1 Neonatal Death in a Preterm Live Birth GAIA Level 1 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 weeks and less than 37 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in a Preterm Live Birth Level 1 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 weeks and less than 37 weeks (where the GA level of certainty is one); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127976 GAIA Level 2 Neonatal Death in a Preterm Live Birth GAIA Level 2 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 and less than 37 weeks (where the GA level of certainty is either level one or level two); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in a Preterm Live Birth Level 2 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 28 and less than 37 weeks (where the GA level of certainty is either level one or level two); OR b) Birth weight greater than or equal to 1000g but less than 2500g; third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127977 GAIA Level 3 Neonatal Death in a Preterm Live Birth GAIA Level 3 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 7 months but less than 9 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in a Preterm Live Birth Level 3 Neonatal Death in a Preterm Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 7 months but less than 9 months according to parent/family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127978 GAIA Level 1 Neonatal Death in a Term Live Birth GAIA Level 1 Neonatal Death in a Term Live Birth is defined by four criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 37 weeks (a GA level of certainty of one); third, at least one of the following requirements must be met: a) Birth weight greater than 2500g; OR b) Documented intra-uterine growth retardation if weight is less than or equal to 2500g; fourth, the death of the infant within the first 28 days of life must be documented. Level 1 Neonatal Death in a Term Live Birth Level 1 Neonatal Death in a Term Live Birth is defined by four criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 37 weeks (a GA level of certainty of one); third, at least one of the following requirements must be met: a) Birth weight greater than 2500g; OR b) Documented intra-uterine growth retardation if weight is less than or equal to 2500g; fourth, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127979 GAIA Level 2 Neonatal Death in a Term Live Birth GAIA Level 2 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 37 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 2500g; third, the death of the infant within the first 28 days of life must be documented. Level 2 Neonatal Death in a Term Live Birth Level 2 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, at least one of the following requirements must be met: a) Gestational age greater than or equal to 37 weeks (where the GA level of certainty is either level one or level two) OR b) Birth weight greater than or equal to 2500g; third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127980 GAIA Level 3 Neonatal Death in a Term Live Birth GAIA Level 3 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 9 months according to parent/ family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. Level 3 Neonatal Death in a Term Live Birth Level 3 Neonatal Death in a Term Live Birth is defined by three criteria: first, the infant must be live born; second, the gestational age must be greater than or equal to 9 months according to parent/ family member/delivery attendant (a GA level of certainty of either level two or three); third, the death of the infant within the first 28 days of life must be documented. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127981 GAIA Level 1 Maternal Immunization GAIA Level 1 Maternal immunization is defined by three criteria: first, the pregnancy must be confirmed by either a positive pregnancy test or by ultrasound confirmation; second, the date/time of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the details of vaccine must include the lot number and the date of immunization. Level 1 Maternal Immunisation Level 1 Maternal immunization is defined by three criteria: first, the pregnancy must be confirmed by either a positive pregnancy test or by ultrasound confirmation; second, the date/time of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the details of vaccine must include the lot number and the date of immunization. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127982 GAIA Level 2 Maternal Immunization GAIA Level 2 Maternal immunization is defined by three criteria: first, pregnancy must be confirmed by both the patient's report of cessation of menstrual period and by physical exam revealing a gravid uterus; second, the date (at least month and year) of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the medical record must contain details of the disease against which the individual was vaccinated. Level 2 Maternal Immunisation Level 2 Maternal immunization is defined by three criteria: first, pregnancy must be confirmed by both the patient's report of cessation of menstrual period and by physical exam revealing a gravid uterus; second, the date (at least month and year) of the immunization of the pregnant woman must be recorded in the medical records by the health care worker who administered/witnessed administration of vaccine; third, the medical record must contain details of the disease against which the individual was vaccinated. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127983 GAIA Level 3 Maternal Immunization GAIA Level 3 Maternal immunization is defined by two criteria: first, the woman/medical attendant reports the pregnancy; second, the woman reports receipt of vaccination during pregnancy, but no formal recording of the immunization is available. Level 3 Maternal Immunisation Level 3 Maternal immunization is defined by two criteria: first, the woman/medical attendant reports the pregnancy; second, the woman reports receipt of vaccination during pregnancy, but no formal recording of the immunization is available. C126853 GAIA Neonatal Death Level of Diagnostic Certainty Terminology C C127984 GAIA Level 1 Neonatal Invasive Bloodstream Infection GAIA Level 1 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, identification of a recognized pathogen from a normally sterile site using a validated method; second, if a normally non-pathogenic organism is isolated from blood cultures the following two requirements must be met: a) The cultures must be obtained from two different sites OR taken at two different times; b) One or more of the level 2 criteria must be present. Level 1 Neonatal Blood Stream Infection Level 1 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, identification of a recognized pathogen from a normally sterile site using a validated method; second, if a normally non-pathogenic organism is isolated from blood cultures the following two requirements must be met: a) The cultures must be obtained from two different sites OR taken at two different times; b) One or more of the level 2 criteria must be present. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127985 GAIA Level 2 Neonatal Invasive Bloodstream Infection GAIA Level 2 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 diagnostic certainty; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachycardia or new or more frequent episodes of bradycardia; c) New or more frequent episodes of apnea or increased oxygen requirement or increased requirement for ventilatory support; d) Lethargy or moving only when stimulated or hypotonia or irritability; e) Difficulty in feeding or abdominal distention; f) Pallor or poor perfusion or hypotension; g) Abnormal white cell count or I/T (immature/total neutrophil) ratio greater than 0.2; h) Abnormal platelet count; i) Increased number of inflammatory markers (CRP, procalcitonin); j) Metabolic acidosis as defined by a base excess. Level 2 Neonatal Blood Stream Infection Level 2 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 diagnostic certainty; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachycardia or new or more frequent episodes of bradycardia; c) New or more frequent episodes of apnea or increased oxygen requirement or increased requirement for ventilatory support; d) Lethargy or moving only when stimulated or hypotonia or irritability; e) Difficulty in feeding or abdominal distention; f) Pallor or poor perfusion or hypotension; g) Abnormal white cell count or I/T (immature/total neutrophil) ratio greater than 0.2; h) Abnormal platelet count; i) Increased number of inflammatory markers (CRP, procalcitonin); j) Metabolic acidosis as defined by a base excess. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127986 GAIA Level 3 Neonatal Invasive Bloodstream Infection GAIA Level 3 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 or 2 diagnostic certainty; second, two or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or severe chest indrawing or grunting or cyanosis; c) Change in level of activity; d) History of feeding difficulty; e) History of convulsions. Level 3 Neonatal Blood Stream Infection Level 3 Neonatal Invasive Blood Stream Infection is defined by two criteria: first, the criteria does not meet the requirements for level 1 or 2 diagnostic certainty; second, two or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or severe chest indrawing or grunting or cyanosis; c) Change in level of activity; d) History of feeding difficulty; e) History of convulsions. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127987 GAIA Level 1 Neonatal Infectious Meningitis GAIA Level 1 Neonatal Infectious Meningitis is defined by two criteria: first, the recognized pathogen must be identified, using a validated method, from cerebrospinal fluid (CSF); second, if an organism normally considered to be non-pathogenic is identified from the CSF, level 1 of diagnostic certainty additionally requires all level 2 criteria: i.e. CSF pleocytosis AND temperature criteria AND one or more clinical criteria. Level 1 Neonatal Meningitis Level 1 Neonatal Infectious Meningitis is defined by two criteria: first, the recognized pathogen must be identified, using a validated method, from cerebrospinal fluid (CSF); second, if an organism normally considered to be non-pathogenic is identified from the CSF, level 1 of diagnostic certainty additionally requires all level 2 criteria: i.e. CSF pleocytosis AND temperature criteria AND one or more clinical criteria. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127988 GAIA Level 2 Neonatal Infectious Meningitis GAIA Level 2 Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis OR positive IgM antibodies to a specific pathogen in the CSF; second, a recognized pathogen is identified, using a validated method from a normally sterile site other than the CSF; third, a temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, one or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. Level 2 Neonatal Meningitis Level 2 Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis OR positive IgM antibodies to a specific pathogen in the CSF; second, a recognized pathogen is identified, using a validated method from a normally sterile site other than the CSF; third, a temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, one or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127989 GAIA Level 3a Neonatal Infectious Meningitis GAIA Level 3a Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis; second, NO recognized pathogen is identified, using a validated method, from a normally sterile site; third, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, three or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. Level 3a Neonatal Bacterial/Fungal/Viral Meningitis Level 3a Neonatal Infectious Meningitis is defined by four criteria: first, CSF pleocytosis; second, NO recognized pathogen is identified, using a validated method, from a normally sterile site; third, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; fourth, three or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127990 GAIA Level 3b Neonatal Infectious Meningitis GAIA Level 3b Neonatal Infectious Meningitis is defined by three criteria: first, no lumbar puncture is done or no sample is available; second, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; third, four or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. Level 3b Neonatal Meningitis Level 3b Neonatal Infectious Meningitis is defined by three criteria: first, no lumbar puncture is done or no sample is available; second, temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; third, four or more of the following requirements must be met: a) History of convulsions; b) Lethargy or irritability; c) Coma; d) Apnea; e) Bulging fontanel; f) Neck stiffness. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127991 GAIA Level 1 Neonatal Respiratory Tract Infection GAIA Level 1 Neonatal Respiratory Tract Infection is defined by two criteria: first, a new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray OR a recognized virus identified using a validated assay from an upper respiratory sample OR a recognized pathogen identified, using a validated method, from a normally sterile site; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. Level 1 Neonatal Respiratory Tract Infection Level 1 Neonatal Respiratory Tract Infection is defined by two criteria: first, a new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray OR a recognized virus identified using a validated assay from an upper respiratory sample OR a recognized pathogen identified, using a validated method, from a normally sterile site; second, three or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C127992 GAIA Level 2 Neonatal Respiratory Tract Infection GAIA Level 2 Neonatal Respiratory Tract Infection is defined by two criteria:first, new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray; second, four or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. Level 2 Neonatal Respiratory Tract Infection Level 2 Neonatal Respiratory Tract Infection is defined by two criteria:first, new or progressive or persistent infiltrate or shadowing or fluid in the intrapleural cavity or interlobar fissure on chest X-ray; second, four or more of the following requirements must be met: a) Temperature greater than or equal to 37.5 degrees C or less than 35.5 degrees C; b) Tachypnea or nasal flaring or chest indrawing or grunting; c) Desaturations or increased oxygen requirements or increased ventilator requirements or oxygen saturation less than 95%; d) Apnea; e) Increased respiratory secretions or increased suctioning requirements; f) Cough, wheeze, or crepitations; g) Increased CRP or procalcitonin. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C128014 GAIA Level 2A Assessment of Gestational Age GAIA Level 2A Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Certain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks), (If LMP and ultrasound (U/S) do not correlate, default to U/S GA assessment); OR b) Certain LMP date with first trimester physical examination. Level 2A Assessment of Prematurity and Gestational Age Level 2A Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Certain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks), (If LMP and ultrasound (U/S) do not correlate, default to U/S GA assessment); OR b) Certain LMP date with first trimester physical examination. C126855 GAIA Preterm Birth Level of Diagnostic Certainty Terminology C C128015 GAIA Level 2B Assessment of Gestational Age GAIA Level 2B Assessment of Gestational Age is defined by the following criteria: uncertain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks). Level 2B Assessment of Prematurity and Gestational Age Level 2B Assessment of Gestational Age is defined by the following criteria: uncertain last menstrual period (LMP) date with second trimester scan (14 0/7 weeks to 27 6/7 weeks). C126855 GAIA Preterm Birth Level of Diagnostic Certainty Terminology C C128016 GAIA Level 3A Assessment of Gestational Age GAIA Level 3A Assessment of Gestational Age is defined by the presence at least one of the following criteria: a) Certain last menstrual period (LMP) date with third trimester scan (28 0/7 weeks or more); OR b) Certain LMP date with confirmatory second trimester fundal height (FH); OR c) Certain LMP date with birth weight; OR d) Uncertain LMP date with first trimester physical examination. Level 3A Assessment of Prematurity and Gestational Age Level 3A Assessment of Gestational Age is defined by the presence at least one of the following criteria: a) Certain last menstrual period (LMP) date with third trimester scan (28 0/7 weeks or more); OR b) Certain LMP date with confirmatory second trimester fundal height (FH); OR c) Certain LMP date with birth weight; OR d) Uncertain LMP date with first trimester physical examination. C126855 GAIA Preterm Birth Level of Diagnostic Certainty Terminology C C128017 GAIA Level 3B Assessment of Gestational Age GAIA Level 3B Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Uncertain last menstrual period (LMP) date with fundal height (FH); OR b) Uncertain LMP date with newborn physical assessment; OR c) Uncertain LMP date with birth weight. Level 3B Assessment of Prematurity and Gestational Age Level 3B Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) Uncertain last menstrual period (LMP) date with fundal height (FH); OR b) Uncertain LMP date with newborn physical assessment; OR c) Uncertain LMP date with birth weight. C126855 GAIA Preterm Birth Level of Diagnostic Certainty Terminology C C128018 GAIA Level 1 Antepartum Stillbirth GAIA Level 1 Antepartum Stillbirth is defined by four criteria: first, one or more of the following three requirements must be met: a) Prenatal ultrasound examination (e.g. basic ultrasound or special ultrasound with Doppler) documenting an absence of fetal cardiac activity or movement before the onset of labor; b) Radiology findings consistent with intrauterine fetal death; c) Delivery of an infant with no of signs of life at birth, including no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and Apgar scores of 0 at both 1 and 5 minutes. The determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, the following three criteria must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) OR non-electronic devices (e.g. stethoscope, fetoscope, or Pinard horn) that documents the absence of a fetal heartbeat; third, one of the following two requirements must be met: a) Attended delivery, followed by a post-delivery physical examination of the fetus by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with antepartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, nurse practitioner, a physician's assistant, or other qualified trained practitioner); OR b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1 in GA assessment algorithm). Level 1 Antepartum Stillbirth Level 1 Antepartum Stillbirth is defined by four criteria: first, one or more of the following three requirements must be met: a) Prenatal ultrasound examination (e.g. basic ultrasound or special ultrasound with Doppler) documenting an absence of fetal cardiac activity or movement before the onset of labor; b) Radiology findings consistent with intrauterine fetal death; c) Delivery of an infant with no of signs of life at birth, including no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and Apgar scores of 0 at both 1 and 5 minutes. The determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, the following three criteria must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) OR non-electronic devices (e.g. stethoscope, fetoscope, or Pinard horn) that documents the absence of a fetal heartbeat; third, one of the following two requirements must be met: a) Attended delivery, followed by a post-delivery physical examination of the fetus by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with antepartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, nurse practitioner, a physician's assistant, or other qualified trained practitioner); OR b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1 in GA assessment algorithm). C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128019 GAIA Level 2 Antepartum Stillbirth GAIA Level 2 Antepartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; third, one or more of the following two requirements must be met: a) Attended delivery followed by a post-delivery physical examination of the fetus that is performed by specialist or qualified trained practitioner appropriate to the health care setting, and that is consistent with antepartum death; b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). Level 2 Antepartum Stillbirth Level 2 Antepartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more; b) Maternal physical examination confirming the absence of fetal movement; c) Auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; third, one or more of the following two requirements must be met: a) Attended delivery followed by a post-delivery physical examination of the fetus that is performed by specialist or qualified trained practitioner appropriate to the health care setting, and that is consistent with antepartum death; b) fetal/placental pathology report that is consistent with antepartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition, as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128020 GAIA Level 3 Antepartum Stillbirth GAIA Level 3 Antepartum Stillbirth is defined by three criteria: first, delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more prior to delivery; b) Report of auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; c) Non-attended delivery followed by a post-delivery physical examination of the fetus that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with antepartum death; d) a verbal history provided by a trained health care provider, non-medical witness, or the mother of the fetus documenting that the fetus was born with no signs of life, was unresponsive to resuscitation efforts immediately after delivery, and had physical features consistent with antepartum death; third, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters. Level 3 Antepartum Stillbirth Level 3 Antepartum Stillbirth is defined by three criteria: first, delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, one or more of the following three requirements must be met: a) Maternal report of the absence of fetal movement for 24 hours or more prior to delivery; b) Report of auscultation for fetal heart tones using electronic devices (e.g. handheld Doppler or fetal heart rate monitor) or non-electronic devices (e.g. stethoscope, fetoscope or Pinard horn) that documents the absence of a fetal heartbeat; c) Non-attended delivery followed by a post-delivery physical examination of the fetus that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with antepartum death; d) a verbal history provided by a trained health care provider, non-medical witness, or the mother of the fetus documenting that the fetus was born with no signs of life, was unresponsive to resuscitation efforts immediately after delivery, and had physical features consistent with antepartum death; third, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters. C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128021 GAIA Level 4 Antepartum Stillbirth GAIA Level 4 Antepartum Stillbirth is defined by two criteria: first, a report of a stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. Level 4 Antepartum Stillbirth Level 4 Antepartum Stillbirth is defined by two criteria: first, a report of a stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128022 GAIA Level 1 Intrapartum Stillbirth GAIA Level 1 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, evidence of a live fetus prior to the onset of labor (confirmed by documentation of fetal movement and of fetal heart tones by ultrasound prior to onset of labor). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with intrapartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, or other qualified trained practitioner); fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal-neonatal parameters (level 1 in GA assessment algorithm). Level 1 Intrapartum Stillbirth Level 1 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant with no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry; second, evidence of a live fetus prior to the onset of labor (confirmed by documentation of fetal movement and of fetal heart tones by ultrasound prior to onset of labor). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination by an obstetrician, a neonatologist, a paediatrician, a maternal-fetal medicine specialist, or a pathologist that is consistent with intrapartum death. In a setting where access to a specialist is not feasible, diagnosis by a health care provider trained or experienced to make the diagnosis is acceptable (e.g. general practice physician, mid-wife, or other qualified trained practitioner); fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal-neonatal parameters (level 1 in GA assessment algorithm). C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128023 GAIA Level 2 Intrapartum Stillbirth GAIA Level 2 Intrapartum Stillbirth is defined by four criteria: first, the delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry OR documentation of lack of response to resuscitation efforts; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor and documentation of fetal heart tones by auscultation or hand held Doppler). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and which is consistent with intrapartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). Level 2 Intrapartum Stillbirth Level 2 Intrapartum Stillbirth is defined by four criteria: first, the delivery of an infant with no signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no respirations, and an Apgar score of 0 at both 1 and 5 minutes. Determination of the absence of signs of life is made by physical examination after delivery, with or without electronic monitoring of heart rate, respiratory rate, and pulse oximetry OR documentation of lack of response to resuscitation efforts; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor and documentation of fetal heart tones by auscultation or hand held Doppler). NOTE: In the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, attended delivery followed by post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and which is consistent with intrapartum death; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 1-2 in GA assessment algorithm). C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128024 GAIA Level 3 Intrapartum Stillbirth GAIA Level 3 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant who is reported to have no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor OR auscultation of fetal heart tones). NOTE: in the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, a non-attended delivery followed by a post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with intrapartum death, or a verbal history that is provided by a trained health care provider, a non-medical witness, or the mother of the fetus that documents a fetus born with no signs of life and who was unresponsive to resuscitation efforts immediately after birth; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 2-3 in GA assessment algorithm). Level 3 Intrapartum Stillbirth Level 3 Intrapartum Stillbirth is defined by four criteria: first, delivery of an infant who is reported to have no of signs of life at birth, including the following: no spontaneous movements, no umbilical cord pulse, no heartbeat, no crying, no spontaneous respirations or chest movement, and full body cyanosis; second, evidence of a live fetus prior to the onset of labor (maternal report of fetal movement prior to the onset of labor OR auscultation of fetal heart tones). NOTE: in the absence of evidence of a live fetus prior to the onset of labor, the fetal death should be reported as a stillbirth or an antepartum stillbirth; third, a non-attended delivery followed by a post-delivery physical examination that is performed by a health care professional who meets the standard of care in the immediate health care setting, and that is consistent with intrapartum death, or a verbal history that is provided by a trained health care provider, a non-medical witness, or the mother of the fetus that documents a fetus born with no signs of life and who was unresponsive to resuscitation efforts immediately after birth; fourth, gestational age within the pre-defined range for selected stillbirth definition as assessed by maternal and/or fetal parameters (level 2-3 in GA assessment algorithm). C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C128025 GAIA Level 4 Intrapartum Stillbirth GAIA Level 4 Intrapartum Stillbirth is defined by two criteria: first, a report of stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. Level 4 Intrapartum Stillbirth Level 4 Intrapartum Stillbirth is defined by two criteria: first, a report of stillbirth, but the fetus is unavailable for physical examination after birth so no objective assessment can be made; second, maternal information is insufficient to assess gestational age. C126856 GAIA Stillbirth Level of Diagnostic Certainty Terminology C C127994 GAIA Level 1 Non-reassuring Fetal Status GAIA Level 1 Non-reassuring Fetal Status is defined by two criteria: first, a Category III fetal heart rate tracing detected via continuous cardiotocography as defined by the NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern; third, umbilical cord blood analysis that is consistent with metabolic acidosis (pH less than 7.0 and a base deficit greater than 12mmol/L). Level 1 Non-reassuring Fetal Status Level 1 Non-reassuring Fetal Status is defined by two criteria: first, a Category III fetal heart rate tracing detected via continuous cardiotocography as defined by the NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern; third, umbilical cord blood analysis that is consistent with metabolic acidosis (pH less than 7.0 and a base deficit greater than 12mmol/L). C126857 GAIA Non-Reassuring Fetal Status Level of Diagnostic Certainty Terminology C C127995 GAIA Level 2 Non-reassuring Fetal Status GAIA Level 2 Non-reassuring Fetal Status is defined by the presence of at least one of the following two criteria: first, a category III fetal heart rate tracing detected via continuous cardiotocography as defined by NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern. Level 2 Non-reassuring Fetal Status Level 2 Non-reassuring Fetal Status is defined by the presence of at least one of the following two criteria: first, a category III fetal heart rate tracing detected via continuous cardiotocography as defined by NICHD; second, one of the following two conditions must be met: a) an absent baseline fetal heart rate variability AND any of the following: recurrent late decelerations, recurrent variable deceleration, bradycardia (less than 110 bpm); OR b) a sinusoidal pattern. C126857 GAIA Non-Reassuring Fetal Status Level of Diagnostic Certainty Terminology C C127997 GAIA Level 1 Maternal Death GAIA Level 1 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy as established by any one of the following documented requirements: a) Ultrasound examination; b) Fetal heart tones; c) Positive serum or urine human chorionic gonadotropin pregnancy test; d) Delivery of a neonate or other products of conception (abortus, stillborn); second, the death of the mother while pregnant or within 42 days of the termination of a pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death as one of the following: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental. Level 1 Maternal Death Level 1 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy as established by any one of the following documented requirements: a) Ultrasound examination; b) Fetal heart tones; c) Positive serum or urine human chorionic gonadotropin pregnancy test; d) Delivery of a neonate or other products of conception (abortus, stillborn); second, the death of the mother while pregnant or within 42 days of the termination of a pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death as one of the following: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental. C126858 GAIA Maternal Death Level of Diagnostic Certainty Terminology C C127998 GAIA Level 2 Maternal Death GAIA Level 2 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy, in the absence of level 1 criteria, as established by either of the following requirements: a) last menstrual period date; b) Serial symphysio fundal height examinations; second, death of the mother while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. Level 2 Maternal Death Level 2 Maternal Death is defined by three criteria: first, diagnosis of a pregnancy, in the absence of level 1 criteria, as established by either of the following requirements: a) last menstrual period date; b) Serial symphysio fundal height examinations; second, death of the mother while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. C126858 GAIA Maternal Death Level of Diagnostic Certainty Terminology C C127999 GAIA Level 3 Maternal Death GAIA Level 3 Maternal Death is defined by three criteria: first, the absence of level 1 or level 2 criteria for establishing diagnosis of pregnancy, and both the uncertainty of the individual's last menstrual period date and no documented clinical examination; second, death of the mother temporal to pregnancy, childbirth, or the postpartum period when exact timing of death is unknown; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non-obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. Level 3 Maternal Death Level 3 Maternal Death is defined by three criteria: first, the absence of level 1 or level 2 criteria for establishing diagnosis of pregnancy, and both the uncertainty of the individual's last menstrual period date and no documented clinical examination; second, death of the mother temporal to pregnancy, childbirth, or the postpartum period when exact timing of death is unknown; third, documentation of the maternal cause of death wherein one of the following requirements must be met: a) Direct: abortive outcome, hypertensive disorder, obstetric hemorrhage, pregnancy related infection, other obstetric complications, unanticipated complications; b) Indirect: non-obstetric complications; c) Death during pregnancy, childbirth, and the puerperium: other or coincidental; d) Unspecified: unknown or undetermined. C126858 GAIA Maternal Death Level of Diagnostic Certainty Terminology C C128000 GAIA Level 1 Postpartum Hemorrhage GAIA Level 1 Postpartum Hemorrhage is the presence of genital bleeding after delivery, leading to severe maternal outcome (maternal death or maternal near miss) as defined by WHO. Level 1 Postpartum Haemorrhage Level 1 Postpartum Hemorrhage is the presence of genital bleeding after delivery, leading to severe maternal outcome (maternal death or maternal near miss) as defined by WHO. C126859 GAIA Postpartum Hemorrhage Level of Diagnostic Certainty Terminology C C128001 GAIA Level 2 Postpartum Hemorrhage GAIA Level 2 Postpartum Hemorrhage is defined by the presence of the following criteria: genital bleeding after delivery with at least one of the following: a) Measured abnormal bleeding (1000ml or more); or b) Any bleeding leading to hypotension or blood transfusion. Level 2 Postpartum Haemorrhage Level 2 Postpartum Hemorrhage is defined by the presence of the following criteria: genital bleeding after delivery with at least one of the following: a) Measured abnormal bleeding (1000ml or more); or b) Any bleeding leading to hypotension or blood transfusion. C126859 GAIA Postpartum Hemorrhage Level of Diagnostic Certainty Terminology C C128002 GAIA Level 3 Postpartum Hemorrhage GAIA Level 3 Postpartum Hemorrhage is defined by the presence of genital bleeding after delivery that is estimated at 1000ml or more. Level 3 Postpartum Haemorrhage Level 3 Postpartum Hemorrhage is defined by the presence of genital bleeding after delivery that is estimated at 1000ml or more. C126859 GAIA Postpartum Hemorrhage Level of Diagnostic Certainty Terminology C C128003 GAIA Level 1 Preeclampsia GAIA Level 1 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level one diagnostic certainty (proteinuria diagnosed with greater than or equal to 300 mg of protein during 24 hour urine collection OR greater than or equal to 0.3 for spot protein:creatinine ratio.) Level 1 Preeclampsia Level 1 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level one diagnostic certainty (proteinuria diagnosed with greater than or equal to 300 mg of protein during 24 hour urine collection OR greater than or equal to 0.3 for spot protein:creatinine ratio.) C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128004 GAIA Level 2 Preeclampsia GAIA Level 2 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level 2 diagnostic certainty (proteinuria diagnosed with greater than or equal to 1+ protein on urine dipstick). Level 2 Preeclampsia Level 2 Preeclampsia is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, a diagnosis of new onset proteinuria that is a level 2 diagnostic certainty (proteinuria diagnosed with greater than or equal to 1+ protein on urine dipstick). C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128006 GAIA Level 1 Preeclampsia with Severe Features GAIA Level 1 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour); third, the presence of one or more of the following requirements: a) Systolic blood pressure greater than or equal to 160mmHg and/or diastolic blood pressure greater than or equal to 110mmHg, which is confirmed after only minutes; b) Development of severe, persistent headache; c) Development of visual changes; d) Eclampsia; e) New onset thrombocytopenia (platelets less than 100,000/microliter); f) New onset unremitting epigastric pain; g) AST and ALT elevated to twice the upper limit of normal; h) Evidence of liver capsular hematoma or liver rupture (diagnosed on clinical exam or with imaging); i) Worsening renal function, as evidenced by serum creatinine level greater than 1.1 mg/dL, a doubling of the serum creatinine (absent other renal disease), or oliguria (less than 500 cc/24 hours); j) Pulmonary edema (confirmed on either imaging with chest x-ray or on clinical exam). Level 1 Preeclampsia with Severe Features Level 1 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour); third, the presence of one or more of the following requirements: a) Systolic blood pressure greater than or equal to 160mmHg and/or diastolic blood pressure greater than or equal to 110mmHg, which is confirmed after only minutes; b) Development of severe, persistent headache; c) Development of visual changes; d) Eclampsia; e) New onset thrombocytopenia (platelets less than 100,000/microliter); f) New onset unremitting epigastric pain; g) AST and ALT elevated to twice the upper limit of normal; h) Evidence of liver capsular hematoma or liver rupture (diagnosed on clinical exam or with imaging); i) Worsening renal function, as evidenced by serum creatinine level greater than 1.1 mg/dL, a doubling of the serum creatinine (absent other renal disease), or oliguria (less than 500 cc/24 hours); j) Pulmonary edema (confirmed on either imaging with chest x-ray or on clinical exam). C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128007 GAIA Level 2 Preeclampsia with Severe Features GAIA Level 2 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the diagnosis of new onset nausea and vomiting. Level 2 Preeclampsia with Severe Features Level 2 Preeclampsia with Severe Features is defined by three criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the diagnosis of new onset nausea and vomiting. C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128008 GAIA Insufficient Evidence Preeclampsia with Severe Features GAIA Preeclampsia with Severe Features with Insufficient Evidence is a pregnancy with a gestational age greater than or equal to 20 weeks and the inability to measure blood pressure. Insufficient Evidence Preeclampsia with Severe Features Preeclampsia with Severe Features with Insufficient Evidence is a pregnancy with a gestational age greater than or equal to 20 weeks and the inability to measure blood pressure. C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128009 GAIA Level 1 Gestational Hypertension GAIA Level 1 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by 24 hour urine collection less than 300 mg, and spot protein:creatinine ratio less than 0.3). Level 1 Gestational Hypertension Level 1 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements over a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by 24 hour urine collection less than 300 mg, and spot protein:creatinine ratio less than 0.3). C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128010 GAIA Level 2 Gestational Hypertension GAIA Level 2 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by urine dipstick result of negative or trace). Level 2 Gestational Hypertension Level 2 Gestational Hypertension is defined by four criteria: first, the gestational age of the pregnancy must be greater than or equal to 20 weeks; second, a diagnosis of new onset maternal hypertension (systolic blood pressure greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg) that is sustained on two measurements for a minimum of one hour; third, the absence of any severe features (see preeclampsia with severe features category); fourth, the absence of proteinuria (as defined by urine dipstick result of negative or trace). C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C128011 GAIA Gestational Hypertension with Insufficient Evidence GAIA Gestational Hypertension with Insufficient Evidence is defined by two criteria: first, a pregnancy with gestational age greater than or equal to 20 weeks; second, one or more of the following requirements: a) The inability to measure blood pressure; b) The inability to evaluate for proteinuria. Gestational Hypertension with Insufficient Evidence GAIA Gestational Hypertension with Insufficient Evidence is defined by two criteria: first, a pregnancy with gestational age greater than or equal to 20 weeks; second, one or more of the following requirements: a) The inability to measure blood pressure; b) The inability to evaluate for proteinuria. C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology C C127944 GAIA Level 1 Assessment of Premature Preterm Rupture of Membranes GAIA Level 1 Assessment of Premature Preterm Rupture of Membranes is defined by five criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the two following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than 2); fifth, documentation of the membrane rupture by one of the following diagnostic tests: a) Positive intra-amniotic dye-injection method; b) Positive result on amniotic fluid alpha-fetoprotein test kit; c) Amniotic fluid pH measurement (nitrazine paper test); d) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); e) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). Level 1 Assessment of Premature Preterm Rupture of Membranes Level 1 Assessment of Premature Preterm Rupture of Membranes is defined by five criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the two following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than 2); fifth, documentation of the membrane rupture by one of the following diagnostic tests: a) Positive intra-amniotic dye-injection method; b) Positive result on amniotic fluid alpha-fetoprotein test kit; c) Amniotic fluid pH measurement (nitrazine paper test); d) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); e) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127945 GAIA Level 2 Assessment of Premature Preterm Rupture of Membranes GAIA Level 2 Assessment of Premature Preterm Rupture of Membranes is defined by four criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the three following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than; OR c) documentation of the membrane rupture by one of the following diagnostic tests: 1) Positive intra-amniotic dye-injection method; 2) Positive result on amniotic fluid alpha-fetoprotein test kit; 3) Amniotic fluid pH measurement (nitrazine paper test); 4) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); 5) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). Level 2 Assessment of Premature Preterm Rupture of Membranes Level 2 Assessment of Premature Preterm Rupture of Membranes is defined by four criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of fluid on vaginal speculum exam; fourth, one of the three following requirements must be met: a) Visible arborization (ferning) on microscopy of amniotic fluid; OR b) Ultrasound with oligohydramnios (amniotic fluid index (AFI) less than 5, or maximum vertical pocket (MVP) less than; OR c) documentation of the membrane rupture by one of the following diagnostic tests: 1) Positive intra-amniotic dye-injection method; 2) Positive result on amniotic fluid alpha-fetoprotein test kit; 3) Amniotic fluid pH measurement (nitrazine paper test); 4) Amniotic fluid placental alpha macroglobulin-1 protein assay (PAMG-1) test (AmniSure test); 5) Amniotic fluid insulin-like growth factor binding protein (IGFBP-1) test (Actim PROM test). C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127946 GAIA Level 3 Assessment of Premature Preterm Rupture of Membranes GAIA Level 3 Assessment of Premature Preterm Rupture of Membranes is defined by three criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of presumed amniotic fluid, which may be on vaginal speculum examination (pooling in the vagina), on inspection of the perineum (wet perineum due to leakage of fluid from the vagina), or fluid soaked cloth/clothes/sanitary pad. Level 3 Assessment of Premature Preterm Rupture of Membranes Level 3 Assessment of Premature Preterm Rupture of Membranes is defined by three criteria: first, presentation between 24 0/7 and 36 6/7 weeks gestation with a clinical history of rupture of membranes, the fluid from which may be any colour, including clear, blood-tinged, meconium-tinged (fetal stool), or purulent-tinged (yellowish, suggesting infection); second, the patient is determined to not be in preterm labor (having less than or equal to 4 contractions per hour documented clinically or on tocodynometer, with less than 2cm cervical dilation); third, visible leakage of presumed amniotic fluid, which may be on vaginal speculum examination (pooling in the vagina), on inspection of the perineum (wet perineum due to leakage of fluid from the vagina), or fluid soaked cloth/clothes/sanitary pad. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127947 GAIA Level 1 Assessment of Preterm Labor GAIA Level 1 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR transvaginal ultrasound during a two hour period; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. Level 1 Assessment of Preterm Labor Level 1 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR transvaginal ultrasound during a two hour period; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127948 GAIA Level 2 Assessment of Preterm Labor GAIA Level 2 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR by clinical assessment; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. Level 2 Assessment of Preterm Labor Level 2 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by a tocodynometer OR by clinical assessment; third, documented change in length or dilation of the cervix by physical examination, with clinical criteria obtained by digital examination, including: a) Cervical dilation of two centimeters or more at the internal os; b) Cervical length of one centimeter or less; c) greater than or equal to 50% effacement of the cervix. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127949 GAIA Level 3 Assessment of Preterm Labor GAIA Level 3 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by clinical assessment; third, documented changes in cervical dilation or effacement during a two hour period. Level 3 Assessment of Preterm Labor Level 3 Assessment of Preterm Labor is defined by three criteria: first, confirmed delivery of a fetus between 24 0/7 and 36 6/7 weeks gestation; second, greater than four uterine contractions per hour as determined by clinical assessment; third, documented changes in cervical dilation or effacement during a two hour period. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127950 GAIA Level 1 Assessment of Provider Initiated Preterm Delivery GAIA Level 1 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, documentation in the healthcare record as noted by the delivering provider of the absence of any signs or symptoms of spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. Level 1 Assessment of Provider-Initiated Preterm Delivery Level 1 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, documentation in the healthcare record as noted by the delivering provider of the absence of any signs or symptoms of spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127951 GAIA Level 2 Assessment of Provider Initiated Preterm Delivery GAIA Level 2 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, a report from the delivering provider, based on recall, that there were no signs or symptoms of the spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. Level 2 Assessment of Provider-Initiated Preterm Delivery Level 2 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, a report from the delivering provider, based on recall, that there were no signs or symptoms of the spontaneous onset of preterm labor; third, additional documentation of the need to induce labor or to perform a cesarean delivery, resulting in a preterm delivery. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127952 GAIA Level 3 Assessment of Provider Initiated Preterm Delivery GAIA Level 3 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, from recall, the patient reports that there were no signs or symptoms of spontaneous onset of preterm labor; third, from recall, the patient reports that the healthcare provider indicated the need to induce labor or to perform a cesarean delivery between, resulting in preterm delivery. Level 3 Assessment of Provider-Initiated Preterm Delivery Level 3 Assessment of Provider-Initiated Preterm Delivery is defined by three criteria: first, the patient is determined to be between 24 0/7 and 36 6/7 weeks gestation; second, from recall, the patient reports that there were no signs or symptoms of spontaneous onset of preterm labor; third, from recall, the patient reports that the healthcare provider indicated the need to induce labor or to perform a cesarean delivery between, resulting in preterm delivery. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127953 GAIA Level 1 Assessment of Insufficient Cervix GAIA Level 1 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must all be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or with preterm delivery; c) Less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by transvaginal ultrasound or digital examination. Level 1 Assessment of Insufficient Cervix Level 1 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must all be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or with preterm delivery; c) Less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by transvaginal ultrasound or digital examination. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127954 GAIA Level 2 Assessment of Insufficient Cervix GAIA Level 2 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by digital examination. Level 2 Assessment of Insufficient Cervix Level 2 Assessment of Insufficient Cervix is defined by two criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, dilation of the internal cervical os greater than two centimeters as determined by digital examination. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127955 GAIA Level 3 Assessment of Insufficient Cervix GAIA Level 3 Assessment of Insufficient Cervix is defined by three criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, patient reported fetal delivery without painful contractions; third, the patient's history excludes other causes of mid-second trimester delivery. Level 3 Assessment of Insufficient Cervix Level 3 Assessment of Insufficient Cervix is defined by three criteria: first, the following three requirements must be met: a) Presentation between 16 and 23 6/7 weeks gestation; b) Advanced cervical dilation greater than two centimeters, resulting in either treatment with a cerclage (cervical stitch) or preterm delivery; c) less than or equal to four contractions per hour as documented by a tocodynometer, meaning the patient is not in preterm labor; second, patient reported fetal delivery without painful contractions; third, the patient's history excludes other causes of mid-second trimester delivery. C126861 GAIA Pathways to Preterm Birth Level of Diagnostic Certainty Terminology C C127993 GAIA Level 3 Neonatal Respiratory Tract Infection GAIA Level 3 Neonatal Respiratory Tract Infection is defined by the presence of two or more of the following criteria: a) Difficulty in breathing/tachypnea; b) Severe chest indrawing; c) Nasal flaring; d) Grunting; e) Wheeze; f) Stridor. Level 3 Neonatal Respiratory Tract Infection Level 3 Neonatal Respiratory Tract Infection is defined by the presence of two or more of the following criteria: a) Difficulty in breathing/tachypnea; b) Severe chest indrawing; c) Nasal flaring; d) Grunting; e) Wheeze; f) Stridor. C125481 GAIA Terminology C C127996 GAIA Level 3 Non-reassuring Fetal Status GAIA Level 3 Non-reassuring Fetal Status is defined by the presence of the following criteria: A fetal heart pattern that is detected via intermittent auscultation, and that is suggestive of fetal hypoxia, including the following requirements that must be met: a) Baseline fetal heart rate less than 110 bpm or greater than 160 bpm; b) Presence of repetitive or prolonged (greater than 3 minutes) decelerations; c) More than five contractions in a ten minute period. Level 3 Non-reassuring Fetal Status Level 3 Non-reassuring Fetal Status is defined by the presence of the following criteria: A fetal heart pattern that is detected via intermittent auscultation, and that is suggestive of fetal hypoxia, including the following requirements that must be met: a) Baseline fetal heart rate less than 110 bpm or greater than 160 bpm; b) Presence of repetitive or prolonged (greater than 3 minutes) decelerations; c) More than five contractions in a ten minute period. C125481 GAIA Terminology C C128005 GAIA Preeclampsia with Insufficient Evidence GAIA Preeclampsia with Insufficient Evidence is defined as a pregnancy with gestational age greater than or equal to 20 weeks and either a) The inability to measure blood pressure OR b) The inability to evaluate for proteinuria. Preeclampsia with Insufficient Evidence Preeclampsia with Insufficient Evidence is defined as a pregnancy with gestational age greater than or equal to 20 weeks and either a) The inability to measure blood pressure OR b) The inability to evaluate for proteinuria. C125481 GAIA Terminology C C128013 GAIA Level 1 Assessment of Gestational Age GAIA Level 1 Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) the last menstrual period (LMP) or intrauterine insemination (IUI) date or embryo transfer (ET) date with confirmatory first trimester scan (less than or equal to 13 6/7 weeks); OR b) first trimester scan (less than or equal to 13 6/7 weeks). Level 1 Assessment of Prematurity and Gestational Age Level 1 Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) the last menstrual period (LMP) or intrauterine insemination (IUI) date or embryo transfer (ET) date with confirmatory first trimester scan (less than or equal to 13 6/7 weeks); OR b) first trimester scan (less than or equal to 13 6/7 weeks). C125481 GAIA Terminology C C127993 GAIA Level 3 Neonatal Respiratory Tract Infection GAIA Level 3 Neonatal Respiratory Tract Infection is defined by the presence of two or more of the following criteria: a) Difficulty in breathing/tachypnea; b) Severe chest indrawing; c) Nasal flaring; d) Grunting; e) Wheeze; f) Stridor. Level 3 Neonatal Respiratory Tract Infection Level 3 Neonatal Respiratory Tract Infection is defined by the presence of two or more of the following criteria: a) Difficulty in breathing/tachypnea; b) Severe chest indrawing; c) Nasal flaring; d) Grunting; e) Wheeze; f) Stridor. C126854 GAIA Neonatal Infections Level of Diagnostic Certainty Terminology C C128013 GAIA Level 1 Assessment of Gestational Age GAIA Level 1 Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) the last menstrual period (LMP) or intrauterine insemination (IUI) date or embryo transfer (ET) date with confirmatory first trimester scan (less than or equal to 13 6/7 weeks); OR b) first trimester scan (less than or equal to 13 6/7 weeks). Level 1 Assessment of Prematurity and Gestational Age Level 1 Assessment of Gestational Age is defined by the presence of at least one of the following criteria: a) the last menstrual period (LMP) or intrauterine insemination (IUI) date or embryo transfer (ET) date with confirmatory first trimester scan (less than or equal to 13 6/7 weeks); OR b) first trimester scan (less than or equal to 13 6/7 weeks). C126855 GAIA Preterm Birth Level of Diagnostic Certainty Terminology C C127996 GAIA Level 3 Non-reassuring Fetal Status GAIA Level 3 Non-reassuring Fetal Status is defined by the presence of the following criteria: A fetal heart pattern that is detected via intermittent auscultation, and that is suggestive of fetal hypoxia, including the following requirements that must be met: a) Baseline fetal heart rate less than 110 bpm or greater than 160 bpm; b) Presence of repetitive or prolonged (greater than 3 minutes) decelerations; c) More than five contractions in a ten minute period. Level 3 Non-reassuring Fetal Status Level 3 Non-reassuring Fetal Status is defined by the presence of the following criteria: A fetal heart pattern that is detected via intermittent auscultation, and that is suggestive of fetal hypoxia, including the following requirements that must be met: a) Baseline fetal heart rate less than 110 bpm or greater than 160 bpm; b) Presence of repetitive or prolonged (greater than 3 minutes) decelerations; c) More than five contractions in a ten minute period. C126857 GAIA Non-Reassuring Fetal Status Level of Diagnostic Certainty Terminology C C128005 GAIA Preeclampsia with Insufficient Evidence GAIA Preeclampsia with Insufficient Evidence is defined as a pregnancy with gestational age greater than or equal to 20 weeks and either a) The inability to measure blood pressure OR b) The inability to evaluate for proteinuria. Preeclampsia with Insufficient Evidence Preeclampsia with Insufficient Evidence is defined as a pregnancy with gestational age greater than or equal to 20 weeks and either a) The inability to measure blood pressure OR b) The inability to evaluate for proteinuria. C126860 GAIA Preeclampsia Level of Diagnostic Certainty Terminology