CDE Detailed Report

Disease: Facioscapulohumeral Muscular Dystrophy
Subdomain Name: General Health History
CRF: Pregnancy

Displaying 51 - 61 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
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

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
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

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

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

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

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
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
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

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

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

CSV