AeHIN Medical Certificate of Cause of Death (MCCoD) Implementation Guide
0.1.0 - Draft for AeHIN Member Review Asia

Bangladesh Core FHIR Implementation Guide - Published by Ministry of Health and Family Welfare. See the Directory of published versions

: MCCoD Pregnancy Timing Relative to Death Codes - XML Representation

Draft as of 2026-05-21

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="mccod-pregnancy-status-codes"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ValueSet mccod-pregnancy-status-codes</b></p><a name="mccod-pregnancy-status-codes"> </a><a name="hcmccod-pregnancy-status-codes"> </a><ul><li>Include these codes as defined in <a href="CodeSystem-mccod-pregnancy-timing.html"><code>http://mccod.w3datanet.com/fhir/CodeSystem/mccod-pregnancy-timing</code></a><span title="Version is not explicitly stated, which means it is fixed to the version provided in this specification"> version &#x1F4E6;0.1.0</span><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="CodeSystem-mccod-pregnancy-timing.html#mccod-pregnancy-timing-when-died">when-died</a></td><td>When she died</td><td>The deceased was pregnant at the time of death.<br/>Corresponds to direct or indirect obstetric death per WHO definition.</td></tr><tr><td><a href="CodeSystem-mccod-pregnancy-timing.html#mccod-pregnancy-timing-within-42-days">within-42-days</a></td><td>Within the 42 days preceding her death</td><td>The deceased was pregnant within 42 days before death but was not<br/>pregnant at the time of death. Corresponds to the WHO puerperal<br/>period definition and late maternal death classification.</td></tr><tr><td><a href="CodeSystem-mccod-pregnancy-timing.html#mccod-pregnancy-timing-43-days-to-1-year">43-days-to-1-year</a></td><td>Within 43 days up to 1 year preceding her death</td><td>The deceased was pregnant between 43 days and 1 year before death.<br/>Corresponds to the WHO late maternal death surveillance window.</td></tr><tr><td><a href="CodeSystem-mccod-pregnancy-timing.html#mccod-pregnancy-timing-timing-unknown">timing-unknown</a></td><td>Exact pregnancy timing unknown</td><td>It is known that the deceased was pregnant within the past year<br/>but the exact timing relative to death cannot be determined.</td></tr></table></li></ul></div>
  </text>
  <url
       value="http://mccod.w3datanet.com/fhir/ValueSet/mccod-pregnancy-status-codes"/>
  <version value="0.1.0"/>
  <name value="MCCoDPregnancyStatusVS"/>
  <title value="MCCoD Pregnancy Timing Relative to Death Codes"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2026-05-21"/>
  <publisher value="Asia eHealth Information Network (AeHIN)"/>
  <contact>
    <name value="Asia eHealth Information Network (AeHIN)"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.asiaehealthinformationnetwork.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="AeHIN Secretariat"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.asiaehealthinformationnetwork.org"/>
    </telecom>
  </contact>
  <description
               value="Value set for the timing of pregnancy relative to death, as documented
in the Women of Reproductive Age section of the WHO Medical Certificate
of Cause of Death (MCCoD), Frame B.

This value set is applicable ONLY when:
- The deceased was female aged 15–49 years at time of death, AND
- The question \&quot;Was the deceased pregnant within past year?\&quot; is
  answered Yes

These timing categories are consistent with WHO maternal death
surveillance definitions and ICD-11 Chapter 18 (Pregnancy, childbirth
or the puerperium) coding rules.

**Binding strength at profile level: REQUIRED**
When the pregnancy timing element is present, only these codes
are permitted.

**Relationship to maternal death classification:**
- \&quot;When she died\&quot; → Direct or indirect obstetric death (ICD-11 Chapter 18)
- \&quot;Within 42 days\&quot; → Late maternal death (WHO definition)
- \&quot;43 days to 1 year\&quot; → Late maternal death surveillance window
- \&quot;Exact timing unknown\&quot; → Unspecified maternal death timing

**Whether pregnancy contributed to death** is a separate Yes/No/Unknown
element in the MCCoDPregnancyStatus profile and is not covered by
this value set.

**SNOMED CT cross-reference (informative, not binding):**
- Within 42 days → 59283008 (Death within 42 days of delivery)

**ICD-11 cross-reference (informative, not binding):**
- When she died → JA00–JB6Z (Pregnancy, childbirth or the puerperium)
- Within 42 days → JB60 (maternal death)
- 43 days to 1 year → JB61.0 (Death during pregnancy more than 42 days)
- Exact timing unknown → JB6Z (Unspecified obstetric condition)

**Guidance for member countries:**
Countries SHOULD map these codes to their national maternal death
surveillance system classifications in their national implementation guide."/>
  <jurisdiction>
    <coding>
      <system value="http://un.org"/>
      <code value="142"/>
      <display value="Asia"/>
    </coding>
    <coding>
      <system value="http://hl7.org"/>
      <code value="X1"/>
      <display value="Asia"/>
    </coding>
  </jurisdiction>
  <immutable value="false"/>
  <copyright value="Copyright 2026 AeHIN. Licensed under CC0-1.0."/>
  <compose>
    <include>
      <system
              value="http://mccod.w3datanet.com/fhir/CodeSystem/mccod-pregnancy-timing"/>
      <concept>
        <code value="when-died"/>
        <display value="When she died"/>
      </concept>
      <concept>
        <code value="within-42-days"/>
        <display value="Within the 42 days preceding her death"/>
      </concept>
      <concept>
        <code value="43-days-to-1-year"/>
        <display value="Within 43 days up to 1 year preceding her death"/>
      </concept>
      <concept>
        <code value="timing-unknown"/>
        <display value="Exact pregnancy timing unknown"/>
      </concept>
    </include>
  </compose>
</ValueSet>