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Diagnostic and Psychometric Validation of the FRENCH HELP Scale in Hyperemesis Gravidarum (French-HELP)

11 augustus 2026 bijgewerkt door: Centre Hospitalier Universitaire de Nīmes

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.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Studietype

Observationeel

Inschrijving (Geschat)

300

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

Pregnant women with nausea or vomiting that began before 16 weeks of gestation with no other identifiable cause

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
Interventie / Behandeling
Women with HG
Ander: HELP score
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
Women with severe HG
Ander: HELP score
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

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Tijdsspanne
Area under the curve for the FRENCH HELP score to diagnose hyperemesis gravidarum
Tijdsspanne: Month 21
Month 21
Area under the curve for the PUQE score to diagnose hyperemesis gravidarum
Tijdsspanne: Month 21
Month 21

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Area under the curve for the FRENCH HELP score to diagnose severe hyperemesis gravidarum
Tijdsspanne: Month 21
Month 21
Area under the curve for the PUQE score to diagnose severe hyperemesis gravidarum
Tijdsspanne: Month 21
Month 21
Discordance rate between FRENCH HELP and PUQE
Tijdsspanne: Month 21
Percentage of women reclassified as severe using the HELP score who were not classified as such using the PUQE score
Month 21
Rate of women whose management would have been altered by using the HELP score
Tijdsspanne: Month 21
percentage (%)
Month 21
Predictive values of FRENCH HELP score on miscarriage
Tijdsspanne: Month 21
Classed as pregnancy loss before 15 weeks of gestation
Month 21
Predictive values of PUQE score on miscarriage
Tijdsspanne: Month 21
Classed as pregnancy loss before 15 weeks of gestation
Month 21
Newborn small for gestational age
Tijdsspanne: At birth (Max 9 months)
Classed as birth weight < 10th percentile
At birth (Max 9 months)
Preterm birth
Tijdsspanne: At birth (Max 37 weeks)
Classed as delivery before 37 weeks of gestation
At birth (Max 37 weeks)
Gestational hypertension
Tijdsspanne: Before birth (max 9 months)
Classed as blood pressure >140 mmHg systolic and/or 90 mmHg diastolic occurring after 20 weeks of gestation
Before birth (max 9 months)
Pre-eclampsia
Tijdsspanne: Before birth (max Month 9)
Classed as gestational hypertension and proteinuria >0.3 g/24 hours
Before birth (max Month 9)
Labor characteristics
Tijdsspanne: At birth (Max Month 9)
Classed as: spontaneous labor, induction, cesarean section, instrumental delivery, postpartum hemorrhage
At birth (Max Month 9)
Fetal heart rate abnormalities during labor
Tijdsspanne: At birth (max month 9)
Yes/no
At birth (max month 9)
Birth weight
Tijdsspanne: At birth (max 9 months)
grams
At birth (max 9 months)
newborn Apgar score < 7
Tijdsspanne: At birth (max 9 months)
Yes/no
At birth (max 9 months)
Umbilical cord blood pH
Tijdsspanne: At birth (max 9 months)
At birth (max 9 months)
Umbilical cord blood PCO2
Tijdsspanne: At birth (max 9 months)
mmHg
At birth (max 9 months)
Umbilical cord blood PO2
Tijdsspanne: At birth (max 9 months)
mmHg
At birth (max 9 months)
lactate levels in umbilical arterial blood
Tijdsspanne: At birth (max 9 months)
mmol/L
At birth (max 9 months)
newborns transferred to a neonatal unit
Tijdsspanne: At birth (max 9 months)
Yes/no
At birth (max 9 months)
presence of a congenital malformation
Tijdsspanne: At birth (max 9 months)
Yes/no
At birth (max 9 months)
presence of depression
Tijdsspanne: Month 9
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.
Month 9
Convergent validity of FRENCH HELP against PUQE score
Tijdsspanne: Month 21
PUQE score - 3 questions regarding nausea, vomiting, and retching, scored from 1 to 15, where score is ≥ 13 is classified as severe.
Month 21
Convergent validity of FRENCH HELP against WHOQOL quality-of-life score
Tijdsspanne: Month 21
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").
Month 21

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Centre Hospitalier Universitaire de Nīmes

Onderzoekers

  • Hoofdonderzoeker: Stephanie Huberlant, Centre Hospitalier Universitaire de Nîmes

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 augustus 2026

Primaire voltooiing (Geschat)

1 november 2028

Studie voltooiing (Geschat)

1 november 2028

Studieregistratiedata

Eerst ingediend

11 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

11 augustus 2026

Eerst geplaatst (Werkelijk)

17 augustus 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

17 augustus 2026

Laatste update ingediend die voldeed aan QC-criteria

11 augustus 2026

Laatst geverifieerd

1 augustus 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • AOI GCS/2025/S

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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