Elective Delivery

["Procedure, Performed": "Cesarean Birth"] CSection
  without "In Labor" Labor
    such that Global."EarliestOf" ( Labor.relevantDatetime, Labor.relevantPeriod ) 24 hours or less before start of Global."NormalizeInterval" ( CSection.relevantDatetime, CSection.relevantPeriod )

"Delivery Encounter with Calculated Gestational Age Greater than or Equal to 37 Weeks and Less than 39 Weeks"
  union "Delivery Encounter with Estimated Gestational Age Greater than or Equal to 37 Weeks and Less than 39 Weeks"

PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
  where PCMaternal."CalculatedGestationalAge" ( DeliveryEncounter ) >= 37
    and PCMaternal."CalculatedGestationalAge" ( DeliveryEncounter ) < 39

"Delivery Encounter Near Term" NearTermEncounter
  with "Cesarean Birth Procedure While Not in Labor" CSectionNoLabor
    such that Global."NormalizeInterval" ( CSectionNoLabor.relevantDatetime, CSectionNoLabor.relevantPeriod ) starts during PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter )
  without "Uterine Surgery Procedure" UterineProcedure
    such that Global."NormalizeInterval" ( UterineProcedure.relevantDatetime, UterineProcedure.relevantPeriod ) starts before start of PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter )
  without "Uterine Surgery Diagnosis" UterineDiagnosis
    such that UterineDiagnosis.prevalencePeriod starts before start of PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter )

( "Delivery Encounter Near Term" NearTermEncounter
    with ["Diagnosis": "Conditions Possibly Justifying Elective Delivery Prior to 39 Weeks Gestation"] DiagnosisElectiveDelivery
      such that DiagnosisElectiveDelivery.prevalencePeriod overlaps PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter )
)
  union ( "Delivery Encounter Near Term" NearTermEncounter
      where exists ( NearTermEncounter.diagnoses EncounterDiagnoses
          where EncounterDiagnoses.code in "Conditions Possibly Justifying Elective Delivery Prior to 39 Weeks Gestation"
      )
  )

PCMaternal."Delivery Encounter with Age Range" DeliveryEncounter
  where PCMaternal."CalculatedGestationalAge" ( DeliveryEncounter ) is null
    and ( PCMaternal."LastEstimatedGestationalAge" ( DeliveryEncounter ) >= 37 weeks
        and PCMaternal."LastEstimatedGestationalAge" ( DeliveryEncounter ) < 39 weeks
    )

from
  "Delivery Encounter Near Term" NearTermEncounter,
  "Medical Induction" Induction,
  "In Labor" Labor
  where Global."EarliestOf" ( Labor.relevantDatetime, Labor.relevantPeriod ) during PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter )
    and Global."NormalizeInterval" ( Induction.relevantDatetime, Induction.relevantPeriod ) starts 24 hours or less before Global."EarliestOf" ( Labor.relevantDatetime, Labor.relevantPeriod )
  return NearTermEncounter

"Delivery Encounter Near Term"

"Delivery Encounter with Conditions Justifying Elective Delivery"

["Assessment, Performed": "Labor"]

PCMaternal."Delivery Encounter with Age Range"

["Medication, Administered": "Oxytocin"]
  union ["Medication, Administered": "Dinoprostone"]
  union ["Procedure, Performed": "Medical Induction of Labor"]

"Delivery Encounter with Medical Induction Started While Not In Labor"
  union "Delivery Encounter with Cesarean Birth without Labor or History of Uterine Surgery"

"Encounter with Age Range" EncounterWithAge
  with ["Procedure, Performed": "Delivery Procedures"] DeliveryProcedure
    such that Global."NormalizeInterval" ( DeliveryProcedure.relevantDatetime, DeliveryProcedure.relevantPeriod ) starts during day of "HospitalizationWithEDOBTriageObservation"(EncounterWithAge)

["Encounter, Performed": "Encounter Inpatient"] EncounterInpatient
  where AgeInYearsAt(date from start of EncounterInpatient.relevantPeriod)>= 8
    and AgeInYearsAt(date from start of EncounterInpatient.relevantPeriod)< 65
    and EncounterInpatient.relevantPeriod ends during day of "Measurement Period"

//This definition establishes a variable of CGA (Calculated Gestational Age).  CGA is a supplemental data element to store the calculated gestational age result from the "CalculatedGestationalAge" function.  The data element enables the capturing and saving of the CGA for data analysis post data receipt. Hospitals do not need to submit any additional data to comply with this definition.  
"Delivery Encounter with Age Range" QualifyingEncounter
  let CGA: "CalculatedGestationalAge"(QualifyingEncounter)
  return { QualifyingEncounter, CGA }

["Patient Characteristic Ethnicity": "Ethnicity"]

["Patient Characteristic Payer": "Payer"]

["Patient Characteristic Race": "Race"]

["Patient Characteristic Sex": "ONC Administrative Sex"]

["Diagnosis": "Perforation of Uterus"]
  union ["Diagnosis": "Uterine Window"]
  union ["Diagnosis": "Uterine Rupture"]
  union ["Diagnosis": "Cornual Ectopic Pregnancy"]

["Procedure, Performed": "Classical Cesarean Birth"]
  union ["Procedure, Performed": "Myomectomy"]
  union ["Procedure, Performed": "Transabdominal Cerclage"]
  union ["Procedure, Performed": "Metroplasty"]
  union ["Procedure, Performed": "Uterine Horn"]

PCMaternal."Variable Calculated Gestational Age"

if ( HasStart(period)) then start of period 
  else 
end of period

Earliest(NormalizeInterval(pointInTime, period))

not ( start of period is null
    or start of period = minimum DateTime
)

if pointInTime is not null then Interval[pointInTime, pointInTime]
  else if period is not null then period 
  else null as Interval<DateTime>

// Age = (280-(Estimated Delivery Date minus Reference Date/Delivery Date))/7
( 280 - ( difference in days between "LastTimeOfDelivery"(Encounter)and "FormattedLastEstimatedDeliveryDate"(Encounter)) ) div 7

//While clinically, the Estimated Delivery Date (EDD) is reported as date only, the Quality Data Model does not support "Date" only at this time. Therefore, the "TruncateTime" function is used to convert date only to date and time.  Time is populated as 0000.
if "LastEstimatedDeliveryDate"(Encounter)is not null then TJC."TruncateTime" ( "LastEstimatedDeliveryDate"(Encounter)) 
  else null

//HospitalizationWithEDOBTriageObservation returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter.
Encounter Visit
  let ObsVisit: Last(["Encounter, Performed": "Observation Services"] LastObs
      where LastObs.relevantPeriod ends 1 hour or less on or before start of Visit.relevantPeriod
      sort by 
      end of relevantPeriod
  ),
  VisitStart: Coalesce(start of ObsVisit.relevantPeriod, start of Visit.relevantPeriod),
  EDOBTriageVisit: Last(["Encounter, Performed": "ED Visit and OB Triage"] LastEDOBTriage
      where LastEDOBTriage.relevantPeriod ends 1 hour or less on or before VisitStart
      sort by 
      end of relevantPeriod
  )
  return Interval[Coalesce(start of EDOBTriageVisit.relevantPeriod, VisitStart), 
  end of Visit.relevantPeriod]

//This function identifies the last time the Estimated Delivery Date was assessed 42 weeks or less prior to or on delivery and stores the result of that assessment.  
Last(["Assessment, Performed": "Delivery date Estimated"] EstimatedDateOfDelivery
    where Global."EarliestOf"(EstimatedDateOfDelivery.relevantDatetime, EstimatedDateOfDelivery.relevantPeriod)42 weeks or less before or on "LastTimeOfDelivery"(Encounter)
      and EstimatedDateOfDelivery.result is not null
    sort by Global."EarliestOf"(relevantDatetime, relevantPeriod)
).result

Last(["Assessment, Performed": "Estimated Gestational Age at Delivery"] EstimatedGestationalAge
    where Global."EarliestOf"(EstimatedGestationalAge.relevantDatetime, EstimatedGestationalAge.relevantPeriod)24 hours or less before or on "LastTimeOfDelivery"(Encounter)
      and EstimatedGestationalAge.result is not null
    sort by Global."EarliestOf"(relevantDatetime, relevantPeriod)
).result as Quantity

Last(["Assessment, Performed": "Date and time of obstetric delivery"] TimeOfDelivery
    where Global."EarliestOf"(TimeOfDelivery.relevantDatetime, TimeOfDelivery.relevantPeriod)during "HospitalizationWithEDOBTriageObservation"(Encounter)
      and TimeOfDelivery.result as DateTime during "HospitalizationWithEDOBTriageObservation"(Encounter)
    sort by Global."EarliestOf"(relevantDatetime, relevantPeriod)
).result as DateTime

DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)