CDE Detailed Report
Disease: Facioscapulohumeral Muscular Dystrophy
Subdomain Name: General Health History
CRF: Pregnancy
Displaying 1 - 50 of 61
Subdomain Name: General Health History
CRF: Pregnancy
Displaying 1 - 50 of 61
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C17995 | Pregnancy infection illness text | PregInfectnIllnessTxt | Text specifying any infections or illnesses the participant/subject experienced during this pregnancy | Text specifying any infections or illnesses the participant/subject experienced during this pregnancy | If Yes, specify: | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C16020 | Pregnancy infection illness indicator | PregInfectnIllnessInd | Indicator of whether there were any infections/illnesses that occurred during this pregnancy | Indicator of whether there were any infections/illnesses that occurred during this pregnancy | Did/Has the participant/subject experienced any infections or illnesses during this pregnancy? | Yes, specify;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C19626 | FSHD prenatal testing indicator | FSHDPrenatTestInd | Indicator of whether prenatal testing for FSHD was performed | Indicator of whether prenatal testing for FSHD was performed | Was prenatal testing for FSHD performed? | No;Yes;Unknown | No;Yes (specify below);Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-01-05 13:31:29.0 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C16046 | Pregnancy labor delivery complication indicator | PregLabDelCompInd | Indicator of whether there were complications during labor/delivery | Indicator of whether there were complications during labor/delivery | Did the participant/subject experience any complications during labor/delivery? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If yes, explain the labor/delivery complication. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C10558 | Delivery or pregnancy termination last date and time | DeliveryPregTerminLstDateTime | Date (and time if applicable and known) the female participant/subject last delivered a pregnancy or the pregnancy terminated (e.g., miscarriage, abortion) | Date (and time if applicable and known) the female participant/subject last delivered a pregnancy or the pregnancy terminated (e.g., miscarriage, abortion) | Outcome date | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C16060 | Weight delivery mother unit of measure | WgtDelMotherUoM | Units for the measurement of the participant's/subject's weight at the time she gave birth | Units for the measurement of the participant's/subject's weight at the time she gave birth | Mother's weight at the time of birth | lb;kg | Pounds;Kilograms | Alphanumeric |
Choose one unit |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C17996 | Pregnancy prior history birth defect text | PregPriorHistBirthDefectTxt | Text of any comments about any birth defects that occurred during the participant/subject's previous pregnancies | Text of any comments about any birth defects that occurred during the participant/subject's previous pregnancies | If Yes, specify birth defect | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C16022 | Pregnancy prior history births full-term count | PregPriorHistBirthFulltermCt | Count of the total number of pregnancies the participant/subject has carried for a full term (>= 37 weeks) | Count of the total number of pregnancies the participant/subject has carried to a full term (>= 37 weeks) | Prior full-term (>= 37 weeks) births | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 30 | ||||||||||
| C19627 | FSHD prenatal testing text | FSHDPrenatTestTxt | Text specifying results from FSHD prenatal testing that was performed on the participant/subject | Text specifying results from FSHD prenatal testing that was performed on the participant/subject | If Yes, specify the result: | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-01-05 14:01:43.0 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||||
| C16048 | Tocolytic agents required during preterm labor indicator | ToclytcAgntReqDrnPretermLabInd | Indicator of whether medications used to suppress premature labor were required during preterm labor | Indicator of whether medications used to suppress premature labor were required during preterm labor | Did the participant/subject require tocolytic agents during preterm labor? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If yes, explain the agent(s) administered. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C11065 | Gravida maternal value | GravidaMaternalVal | Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term | Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term | Number of prior pregnancies: | Numeric Values |
Both to term and not to term |
Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
1 | 99 | |||||||||
| C16062 | Pregnancy fetal diagnostic test performed indicator | PregFetDignstcTestPerfmInd | Indicates whether there were any abnormal fetal diagnostic tests performed during the pregnancy | Indicates whether there were any abnormal fetal diagnostic tests performed during the pregnancy | Any abnormal fetal diagnostic tests performed during pregnacy? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C17997 | Pregnancy fetus not normal description text | PregFetusNotNormDescriptTxt | Description of the abnormal pregnancy fetus | Description of the abnormal pregnancy fetus | No, describe | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
||||||||||
| C16023 | Pregnancy prior history births pre-term count | PregPriorHistBirthPretermCt | Count of the total number of pregnancies the participant/subject carried for less than a full term (< 37 weeks) | Count of the total number of pregnancies the participant/subject carried for less than a full term (< 37 weeks) | Prior pre-term (< 37 weeks) births | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
0 | 30 | ||||||||||
| C19628 | Breastfeeding indicator | BreastFeedInd | Indicator of whether the mother breastfed the newborn | Indicator of whether the mother breastfed the newborn | Breastfeeding? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-01-06 15:48:48.0 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C16049 | Birth child date and time | BrthChildDateTime | Date of birth of participant/subject's most recent live birth | Date of birth of participant/subject's most recent live birth | Birth date | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C11078 | Delivery mode type | DeliveryModeTyp | Type of delivery mode of the neonate | Type of delivery mode of the neonate | Delivery type? | Spontaneous;Induced, specify reason | Spontaneous;Induced, specify reason | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16063 | Pregnancy fetal diagnostic test date | PregFetDignstcTestDate | Date the fetal diagnostic testing was performed during the pregnancy | Date the fetal diagnostic testing was performed during the pregnancy | Date(s) of testing | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). |
ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html) | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C17998 | Pregnancy labor delivery complication specification text | PregLabDelCompSpecTxt | Text about the participant/subject's experience with any complications during labor/delivery | Text about the participant/subject's experience with any complications during labor/delivery | If Yes, specify | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
||||||||||
| C16024 | Pregnancy prior history birth defect indicator | PregPriorHistBirthDefectInd | Indicator of whether a birth defect occurred in any of the participant/subject's previous pregnancies | Indicator of whether a birth defect occurred in any of the participant/subject's previous pregnancies | Did a birth defect occur in any previous pregnancy? | Yes, specify;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C19629 | Breastfeeding Absent text | BreastFeedAbsentTxt | Text describing the reason why the mother did not breastfeed | Text describing the reason why the mother did not breastfeed | No (specify the reason) | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-01-06 15:55:21.0 | Pregnancy | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
|||||||||||
| C16050 | Phenotypic sex child type | PhenotypSexChildTyp | Sex of the participant/subject's child based on physical examination | Sex of the participant/subject's child based on physical examination | Birth sex | Female;Male;Unknown | Female;Male;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C11079 | Neonate delivery route type | NeonateDelivRteTyp | Route of delivery of the neonate | Route of delivery of the neonate | Delivery route? | Vaginal;Caesarean;Unknown | Vaginal;Caesarean;Unknown | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16064 | Pregnancy fetal diagnostic test result | PregFetDignstcTestReslt | Results of the fetal diagnostic testing performed during the pregnancy | Results of the fetal diagnostic testing performed during the pregnancy | Results of Fetal Diagnositc Testing | Alphanumeric |
Answer this question if abnormal fetal diagnostic tests performed |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
|||||||||
| C17999 | Tocolytic agents required during preterm specification text | ToclytcAgntReqDrnPretermLabTxt | Text specifying the tocolytic agents the participant/subject required during preterm labor | Text specifying the tocolytic agents the participant/subject required during preterm labor | If Yes, specify | Alphanumeric | No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
||||||||||
| C16026 | Pregnancy prior history loss indicator | PregPriorHistLossInd | Indicator of whether a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occurred in any previous pregnancy | Indicator of whether a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occurred in any previous pregnancy | Did a miscarriage (<= 20 weeks) or stillbirth (> 20 weeks) occur in any previous pregnancy? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C19630 | Breastfeeding Month Count | BreastFeedMoCount | The value of the number of months the mother breastfed | The value of the number of months the mother breastfed | Yes, for __ months | Numeric Values | Adult;Pediatric | Supplemental | 1.00 | 2015-01-06 16:06:46.0 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||||
| C16051 | Birth weight child value | WgtChildVal | Value of the weight of the participant/subject's child at birth | Value of the weight of the participant/subject's child at birth | Birth weight | Numeric Values |
Record in g or oz |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C11080 | Delivery modality type | DeliveryModltyTyp | Type of modality of the participant/subject's intrauterine orientation at delivery | Type of modality of the participant/subject's intrauterine orientation at delivery | Delivery modality type | Breech;Cephalic;Unknown | Breech;Cephalic;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16065 | Congenital anomaly child indicator | CongAnmlChldInd | Indicates whether there were congenital anomalies in the participant's/subject's child | Indicates whether there were congenital anomalies in the participant's/subject's child | Were there any congenital anomalies? | Yes, specify;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If YES, explain the anomalies |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C18000 | Congenital anomalies child specification text | CongAnmlChildSpecTxt | Text specifying any congenital anomalies of the participant/subject | Text specifying any congenital anomalies of the participant/subject | If Yes, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
||||||||||
| C16027 | Pregnancy prior history loss week count | PregPriorHistLossWeekCt | Number of the week of pregnancy during which the stillbirth or miscarriage occurred | Number of the week of pregnancy during which the stillbirth or miscarriage occurred | If Yes, in what week of pregnancy did the miscarriage or stillbirth occur? | Numeric Values | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
1 | 45 | week | |||||||||
| C19632 | Weight pediatric unit of measure | WgtPedUoM | Unit of measure for the pediatric weight numerical value | Unit of measure for the pediatric weight numerical value | g;oz | gram;ounce | Alphanumeric | Adult;Pediatric | Supplemental | 1.00 | 2015-02-18 00:00:00.0 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
2630200 | ||||||||||
| C16053 | Birth length child value | LngthChildVal | Value of the length of the participant's/subject's child at birth | Value of the length of the participant's/subject's child at birth | Birth length | Numeric Values |
Record in inches or centimeters |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C11081 | Delivery caesarean timing status | DeliveryCaesareanTimingStatus | Status of the caesarean delivery | Status of the caesarean delivery | Timing of cesarean | Emergency;Elective | Emergency;Elective | Alphanumeric |
Choose one. Answer only if Cesarean was the delivery route. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16067 | Newborn complication child indicator | NewbrnCompChldInd | Indicates whether there were other newborn complications experienced by the participant's/subject's child | Indicates whether there were other newborn complications experienced by the participant's/subject's child | Were there other newborn complications? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If YES, explain the complications |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C18001 | Newborn complication child specification text | NewbrnCompChldSpecTxt | Text specifying other newborn complications | Text specifying other newborn complications | If Yes, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
||||||||||
| C16028 | Pregnancy prior history toxic exposure type | PregPriorHistToxExposTyp | Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy | Type of any substances or radiation potentially harmful to the embryo or fetus to which the participant/subject has ever been exposed during pregnancy | Has the participant/subject ever had exposure to any of the following during pregnancy? | Concurrent medications;Teratogens;Smoking;Exposure to X-ray;Alcohol;Other, specify | Concurrent medications;Teratogens;Smoking;Exposure to X-ray;Alcohol;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
||||||||||
| C16055 | Full term delivery child indicator | FullTrmDelChldInd | Indicates whether the participant's/subject's child was delivered full-term | Indicates whether the participant's/subject's child was delivered full-term | What the child delivered full-term? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16015 | Prenatal testing type | PrenatalTestTyp | The type of prenatal testing that was performed for the current pregnancy | The type of prenatal testing that was performed for the current pregnancy | Prenatal Test | Ultrasound;Amniocentesis;Screening for neural tube defects;Screening for gestational diabetes before or at 28 weeks;Screening for asymptomatic bacteriuria before or at 16 weeks gestation;Hepatitis B specific antigen screening at first visit;HIV screening at first visit;Group B streptococcus screening (GBS) at 35 to 37 weeks;Maternal serum alpha fetoprotein;Other, specify | Ultrasound;Amniocentesis;Screening for neural tube defects;Screening for gestational diabetes before or at 28 weeks;Screening for asymptomatic bacteriuria before or at 16 weeks gestation;Hepatitis B specific antigen screening at first visit;HIV screening at first visit;Group B streptococcus screening (GBS) at 35 to 37 weeks;Maternal serum alpha fetoprotein;Other, specify | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||||
| C16069 | Placenta umbilical cord abnormality indicator | PlcntaUmblclCrdAbnrmlyInd | Indicates whether the participant/subject experienced any abnormalities of placenta or umbilical cord | Indicates whether the participant/subject experienced any abnormalities of placenta or umbilical cord | Did the newborn experience any abnormalities of placenta or umbilical cord? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
Choose one. If YES, explain the abnormalities |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C18002 | Placenta umbilical cord abnormality specification text | PlcntaUmblclCrdAbnrmlySpecTxt | Text describing placenta or umbilical cord abnormalities | Text describing placenta or umbilical cord abnormalities | If Yes, specify | Alphanumeric | No references available | Adult | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
||||||||||
| C16037 | Pregnancy most recent live born infant indicator | PregMostRecntLveBornInfantInd | Indicates whether the outcome of the participant/subject's most recent pregnancy was a live born infant? | Indicates whether the outcome of the participant/subject's most recent pregnancy was a live born infant? | Was the outcome of the participant/subject's most recent pregnancy a live born infant? | Yes;No;Unknown | Yes;No;Unknown | Alphanumeric |
If 'Yes' is answered, skip to question 3. If 'No' is answered, then complete questions 2a-2c only. If 'Unknown' answered, then Stop. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16056 | Gestational age child value | GestAgeChldVal | Time elapsed between the first day of the last normal menstrual period and the day the participant/subject delivered the neonate | Time elapsed between the first day of the last normal menstrual period and the day the participant/subject delivered the neonate | Indicate gestational age (GA) | Numeric Values |
Record the gestational age of the child in weeks |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
week | |||||||||
| C16016 | Prenatal testing date and time | PrenatalTestDateTime | Date the selected prenatal testing type was performed for the current pregnancy | Date the selected pregnancy prenatal testing type was performed for the current pregnancy | Date(s) of Testing | Date or Date & Time |
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.). Recording date of birth will give the most detailed information required for calculation of age and is recommended as first choice. However, in some studies recording date of birth may elicit discussions on a potential violation of privacy legislation and specifically HIPAA regulations. In these cases, the calculated age should be recorded. |
ISO 8601 - http://www.iso.org/iso/iso_catalogue.htm | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C16169 | Pregnancy outcome type | PregOutcmeTyp | Type of outcome of the pregnancy experienced by the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | Type of outcome of the pregnancy experienced by the participant or the pregnant individual (if the participant contributed sperm to the pregnancy) | Pregnancy outcome | Elective termination;Spontaneous abortion;Fetal death/stillbirth;Unknown | Elective termination;Spontaneous abortion (< 20 weeks);Fetal death/stillbirth (> 20 weeks);Unknown | Alphanumeric |
Choose one. Answer for the female participant/subject only (not the partner). Only answered if No was answered for "Was the outcome of the participant's/subject's most recent pregnancy a live born infant?". Complete this question, outcome date, and was the fetus normal and then stop completing the form. |
No references available | Adult;Pediatric | Supplemental | 4.00 | 2024-03-18 15:21:17.0 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C18829 | Delivery mode induced other text | DeliveryModeOTH | The free-text field related to 'Delivery mode type' for induced delivery mode. Type of delivery mode of the neonate | The free-text field related to 'Delivery mode type' for induced delivery mode. Type of delivery mode of the neonate | Other, specify: | Alphanumeric |
Choose only one |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-25 08:54:08.2 | Pregnancy | General Health History | Participant History and Family History | 4000 |
Free-Form Entry |
|||||||||
| C16040 | Pregnancy fetus normal indicator | PregFtusNormInd | Indicates whether the fetus was normal | Indicates whether the fetus was normal | Was the fetus normal? | Yes;No, describe;Unknown | Yes;No, describe;Unknown | Alphanumeric |
Only answered if No was answered for "Was the outcome of the participant's/subject's most recent pregnancy a live born infant?", and only complete this question, outcome date, and pregnancy outcome, the end form. |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
||||||||
| C16057 | Activity pulse grimace appearance respiration five minute child score | APGARFveMinChldScore | Assessment of a newborn which is recorded at five minutes from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness. This score describes the participant's/subject's child. Activity pulse grimace appearance respiration (APGAR) | Assessment of a newborn which is recorded at five minutes from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness. This score describes the participant's/subject's child. Activity pulse grimace appearance respiration (APGAR | 5-minute APGAR score | Numeric Values |
Record the score (0 - 10 points, inclusive) |
No references available | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History |
Free-Form Entry |
||||||||||
| C16017 | Prenatal testing result | PrenatalTestReslt | Results of the selected prenatal testing type | Results of the selected prenatal testing type | Results of Test | Alphanumeric | Adult;Pediatric | Supplemental | 3.00 | 2013-07-16 14:01:43.01 | Pregnancy | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
