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
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

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

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

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

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

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

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

CSV