Diagnostic and Psychometric Validation of the FRENCH HELP Scale in Hyperemesis Gravidarum (French-HELP)
Severe forms of nausea and vomiting of pregnancy (NVP) are classified as hyperemesis gravidarum (HG). NVP is debilitating in approximately 35% of women impairing daily life and professional activities while negatively affecting family relationships. In 0.3% to 3.6% of pregnancies, the vomiting is intractable and represents the leading cause of hospitalization during the first trimester. Severity of symptoms can sometimes lead women to consider terminating the pregnancy or to decide against future pregnancies.
The most widely used tool for assessing NVP and HG is the PUQE score; it asks three questions regarding nausea, vomiting, and retching, and is scored from 1 to 15. A score of ≥13 classifies NVP as severe. However, the PUQE score does not include questions regarding quality of life, which is a key determinant of HG.
An international definition (the Windsor definition of HG) has been developed, extending beyond mere digestive symptoms. This definition includes: symptom onset in early pregnancy (before 16 weeks of gestation); severe nausea or vomiting; an inability to eat or drink normally; and significant limitation of daily activities or signs of dehydration. This definition aligns better with the full spectrum of symptoms associated with this condition. The US-based Hyperemesis Education and Research (HER) Foundation developed the HELP Score to better assess nausea and vomiting of pregnancy (NVP), particularly severe cases. The tool includes questions regarding the intensity of nausea and vomiting, along with nine additional questions covering hydration, nutrition, treatments and their efficacy, and quality of life. The HELP score ranges from 0 to 60, with scores of 33 to 60 classifying patients as severe; this offers greater scope for assessing levels of severity, and improvement, compared to the PUQE score, which is calculated on a 15-point scale with only 3 points allocated to the severity category.
The HELP score has proved more effective than the PUQE score at identifying patients with severe symptoms requiring intervention, in a study with several methodological limitations, such as reliance on an online questionnaire and a failure to adhere to diagnostic validation standards. Nevertheless, the lack of robust evidence warrants further research using more rigorous methodology to confirm the value of this scoring system.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Stephanie Huberlant
- Numero di telefono: 04 66 68 32 20
- Email: stephanie.huberlant@chu-nimes.fr
Luoghi di studio
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Alès, Francia
- Centre Hospitalier Alès-Cévennes
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Contatto:
- Jeanne-Claire SIX
- Numero di telefono: 04 66 78 32 21
- Email: dr.six@ch-ales.fr
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Béziers, Francia
- CH de Béziers
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Contatto:
- Samantha HUET
- Numero di telefono: 04 67 35 76 07
- Email: samantha.huet@ch-beziers.fr
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Mende, Francia
- CH de Mende
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Contatto:
- Agnès PREVOST-FEREY
- Email: agnesprevostferey@ch-mende.fr
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Montpellier, Francia
- CHU de Montpellier
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Contatto:
- Philippe DERUELLE
- Numero di telefono: 04 67 33 64 86
- Email: p-deruelle@chu-montpellier.fr
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Nîmes, Francia, 30029
- CHU de Nîmes
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Contatto:
- Anissa Megzari
- Numero di telefono: 04.66.68.42.36
- Email: drc@chu-nimes.fr
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Sète, Francia
- CH de Sète
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Contatto:
- Angela MORARU
- Numero di telefono: 04 67 46 57 57
- Email: amoraru@ch-bassindethau.fr
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Toulouse, Francia
- CHU de Toulouse
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Contatto:
- Laure CONNAN
- Numero di telefono: 5 67 77 12 33
- Email: connan.l@chu-toulouse.fr
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- The patient must be a member or beneficiary of a health insurance plan
- Pregnant woman with nausea or vomiting that began during the first trimester of pregnancy (before 16 weeks of gestation) with no other identifiable cause.
- Oral consent given by the participant
Exclusion Criteria:
- The subject is in a period of exclusion determined by a previous study
- The subject unable to provide consent
- It is impossible to give the subject informed information
- The patient is under safeguard of justice or state guardianship
- Presence of a secondary cause for nausea and vomiting (hepatitis, pancreatitis, atypical forms of appendicitis, pyelonephritis, adnexal torsion, hyperthyroidism, or chronic treatments known to induce vomiting).
- Presence of any pre-existing medical condition or situation that could cause vomiting (restrictive bariatric surgery, eating disorders).
- Inability to complete the questionnaires (lack of French language comprehension, illiteracy, intellectual disability, etc.).
- Patient enrolled in a study evaluating a treatment intended to address nausea and vomiting.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Numero di gruppi/coorti
Coorti e interventi
Gruppo / CoorteGruppo / Coorte |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Women with HG
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Evaluation of intensity of nausea and vomiting, covering hydration, diet, treatments and their effectiveness, and quality of life.
The HELP score ranges from 0 to 60-with scores of 33 to 60 classifying patients as severe
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Women with severe HG
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Evaluation of intensity of nausea and vomiting, covering hydration, diet, treatments and their effectiveness, and quality of life.
The HELP score ranges from 0 to 60-with scores of 33 to 60 classifying patients as severe
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Lasso di tempo |
|---|---|
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Area under the curve for the FRENCH HELP score to diagnose hyperemesis gravidarum
Lasso di tempo: Month 21
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Month 21
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Area under the curve for the PUQE score to diagnose hyperemesis gravidarum
Lasso di tempo: Month 21
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Month 21
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Area under the curve for the FRENCH HELP score to diagnose severe hyperemesis gravidarum
Lasso di tempo: Month 21
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Month 21
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Area under the curve for the PUQE score to diagnose severe hyperemesis gravidarum
Lasso di tempo: Month 21
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Month 21
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Discordance rate between FRENCH HELP and PUQE
Lasso di tempo: Month 21
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Percentage of women reclassified as severe using the HELP score who were not classified as such using the PUQE score
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Month 21
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Rate of women whose management would have been altered by using the HELP score
Lasso di tempo: Month 21
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percentage (%)
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Month 21
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Predictive values of FRENCH HELP score on miscarriage
Lasso di tempo: Month 21
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Classed as pregnancy loss before 15 weeks of gestation
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Month 21
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Predictive values of PUQE score on miscarriage
Lasso di tempo: Month 21
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Classed as pregnancy loss before 15 weeks of gestation
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Month 21
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Newborn small for gestational age
Lasso di tempo: At birth (Max 9 months)
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Classed as birth weight < 10th percentile
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At birth (Max 9 months)
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Preterm birth
Lasso di tempo: At birth (Max 37 weeks)
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Classed as delivery before 37 weeks of gestation
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At birth (Max 37 weeks)
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Gestational hypertension
Lasso di tempo: Before birth (max 9 months)
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Classed as blood pressure >140 mmHg systolic and/or 90 mmHg diastolic occurring after 20 weeks of gestation
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Before birth (max 9 months)
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Pre-eclampsia
Lasso di tempo: Before birth (max Month 9)
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Classed as gestational hypertension and proteinuria >0.3 g/24 hours
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Before birth (max Month 9)
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Labor characteristics
Lasso di tempo: At birth (Max Month 9)
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Classed as: spontaneous labor, induction, cesarean section, instrumental delivery, postpartum hemorrhage
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At birth (Max Month 9)
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Fetal heart rate abnormalities during labor
Lasso di tempo: At birth (max month 9)
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Yes/no
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At birth (max month 9)
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Birth weight
Lasso di tempo: At birth (max 9 months)
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grams
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At birth (max 9 months)
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newborn Apgar score < 7
Lasso di tempo: At birth (max 9 months)
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Yes/no
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At birth (max 9 months)
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Umbilical cord blood pH
Lasso di tempo: At birth (max 9 months)
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At birth (max 9 months)
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Umbilical cord blood PCO2
Lasso di tempo: At birth (max 9 months)
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mmHg
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At birth (max 9 months)
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Umbilical cord blood PO2
Lasso di tempo: At birth (max 9 months)
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mmHg
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At birth (max 9 months)
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lactate levels in umbilical arterial blood
Lasso di tempo: At birth (max 9 months)
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mmol/L
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At birth (max 9 months)
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newborns transferred to a neonatal unit
Lasso di tempo: At birth (max 9 months)
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Yes/no
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At birth (max 9 months)
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presence of a congenital malformation
Lasso di tempo: At birth (max 9 months)
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Yes/no
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At birth (max 9 months)
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presence of depression
Lasso di tempo: Month 9
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Measured using the Edinburgh Postnatal Depression Scale - 10 items rated on a scale of 0 to 3, resulting in a total score ranging from 0 to 30.
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Month 9
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Convergent validity of FRENCH HELP against PUQE score
Lasso di tempo: Month 21
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PUQE score - 3 questions regarding nausea, vomiting, and retching, scored from 1 to 15, where score is ≥ 13 is classified as severe.
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Month 21
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Convergent validity of FRENCH HELP against WHOQOL quality-of-life score
Lasso di tempo: Month 21
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WHOQOL-100 questionnaire - 26 questions measuring four domains: physical health, mental health, social relationships, and environment.
Responses to each item are provided using a 5-point Likert scale ranging from 1 (e.g., "Not at all") to 5 (e.g., "Extremely"); these scores are summed and transformed to correspond to a scale ranging from 0 ("poor health-related quality of life") to 100 ("excellent health-related quality of life").
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Month 21
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Stephanie Huberlant, Centre Hospitalier Universitaire de Nîmes
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
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Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- AOI GCS/2025/S
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