CDE Detailed Report

Disease: Facioscapulohumeral Muscular Dystrophy
Sub-Domain: 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 / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
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

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

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

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
C16169 Pregnancy outcome type PregOutcmeTyp Type of outcome of the pregnancy experienced by the participant/subject Type of outcome of the pregnancy experienced by the participant/subject 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 3.00 2013-07-16 14:01:43.01 Pregnancy General Health History Participant History and Family History

Single Pre-Defined Value Selected

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

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. 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

CSV