Elective Delivery

 from
    "Delivery Encounter Near Term" NearTermEncounter,
    ["Procedure, Performed": "Cesarean Birth"] CSection
    let FirstLaborTime: Global."EarliestOf" ( "FirstLabor"(NearTermEncounter).relevantDatetime, "FirstLabor"(NearTermEncounter).relevantPeriod )
    where( not ( FirstLaborTime 24 hours or less before start of Global."NormalizeInterval" ( CSection.relevantDatetime, CSection.relevantPeriod ) )
      and Global."NormalizeInterval" ( CSection.relevantDatetime, CSection.relevantPeriod ) starts during PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter ))
      or (FirstLaborTime is null
      and Global."NormalizeInterval" ( CSection.relevantDatetime, CSection.relevantPeriod ) starts during PCMaternal."HospitalizationWithEDOBTriageObservation" ( NearTermEncounter ))
    return NearTermEncounter

  "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"
    union "Delivery Encounter With Gestational Age Greater Than Or Equal To 37 Weeks And Less Than 39 Weeks Based On Coding"

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

  "Cesarean Birth Procedure While Not In Labor" CSectionNoLabor
    without "Uterine Surgery Procedure" UterineProcedure
      such that Global."NormalizeInterval" ( UterineProcedure.relevantDatetime, UterineProcedure.relevantPeriod ) starts before start of PCMaternal."HospitalizationWithEDOBTriageObservation" ( CSectionNoLabor )
    without "Uterine Surgery Diagnosis" UterineDiagnosis
      such that UterineDiagnosis.prevalencePeriod starts before start of PCMaternal."HospitalizationWithEDOBTriageObservation" ( CSectionNoLabor )

  ( "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
      )

  PCMaternal."Delivery Encounter With Age Range" DeliveryEncounter
    let CGA: PCMaternal."CalculatedGestationalAge" ( DeliveryEncounter ),
    EGA: PCMaternal."LastEstimatedGestationalAge" ( DeliveryEncounter )
    where CGA is null
      and EGA is null
      and exists ( DeliveryEncounter.diagnoses EncounterDiagnoses
          where EncounterDiagnoses.code in "37 to 38 Weeks Gestation"
      )

  from
    "Delivery Encounter Near Term" NearTermEncounter,
    "Medical Induction" Induction
    let FirstLaborTime: Global."EarliestOf" ( "FirstLabor"(NearTermEncounter).relevantDatetime, "FirstLabor"(NearTermEncounter).relevantPeriod )
    where Global."NormalizeInterval" ( Induction.relevantDatetime, Induction.relevantPeriod ) starts 24 hours or less before FirstLaborTime
    return NearTermEncounter

  "Delivery Encounter Near Term"

  "Delivery Encounter With Conditions Justifying Elective Delivery"

  ["Encounter, Performed": "Encounter Inpatient"] EncounterInpatient
    where EncounterInpatient.relevantPeriod ends during day of "Measurement Period"

  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 "HospitalizationWithEDOBTriageObservation"(EncounterWithAge)

  Global."Inpatient Encounter" InpatientEncounter
    where AgeInYearsAt(date from start of InpatientEncounter.relevantPeriod) >= 8
      and AgeInYearsAt(date from start of InpatientEncounter.relevantPeriod) < 65

  //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" DeliveryEncounter
    let CGA: "CalculatedGestationalAge"(DeliveryEncounter)
    return { DeliveryEncounter, CGA }

  ["Patient Characteristic Ethnicity": "Ethnicity"]

  ["Patient Characteristic Payer": "Payer Type"]

  ["Patient Characteristic Race": "Race"]

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

  PCMaternal."Variable Calculated Gestational Age"

  ["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"]

  First(["Assessment, Performed": "Labor"] LaborAssessed
      where Global."EarliestOf"(LaborAssessed.relevantDatetime, LaborAssessed.relevantPeriod) during PCMaternal."HospitalizationWithEDOBTriageObservation"(Encounter)
      sort by Global."EarliestOf"(relevantDatetime, relevantPeriod)
  )

  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 "LastEstimatedDeliveryDate"(Encounter) ) ) div 7

  //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 as DateTime

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