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.
Visão geral do estudo
Status
Status
Condições
Condições
Intervenção / Tratamento
Intervenção / Tratamento
Tipo de estudo
Tipo de estudo
Inscrição (Estimado)
Inscrição
Contactos e Locais
Contato de estudo
Contato de estudo
- Nome: Stephanie Huberlant
- Número de telefone: 04 66 68 32 20
- E-mail: stephanie.huberlant@chu-nimes.fr
Locais de estudo
-
-
-
Alès, França
- Centre Hospitalier Alès-Cévennes
-
Contato:
- Jeanne-Claire SIX
- Número de telefone: 04 66 78 32 21
- E-mail: dr.six@ch-ales.fr
-
Béziers, França
- CH de Béziers
-
Contato:
- Samantha HUET
- Número de telefone: 04 67 35 76 07
- E-mail: samantha.huet@ch-beziers.fr
-
Mende, França
- CH de Mende
-
Contato:
- Agnès PREVOST-FEREY
- E-mail: agnesprevostferey@ch-mende.fr
-
Montpellier, França
- CHU de Montpellier
-
Contato:
- Philippe DERUELLE
- Número de telefone: 04 67 33 64 86
- E-mail: p-deruelle@chu-montpellier.fr
-
Nîmes, França, 30029
- CHU de Nîmes
-
Contato:
- Anissa Megzari
- Número de telefone: 04.66.68.42.36
- E-mail: drc@chu-nimes.fr
-
Sète, França
- CH de Sète
-
Contato:
- Angela MORARU
- Número de telefone: 04 67 46 57 57
- E-mail: amoraru@ch-bassindethau.fr
-
Toulouse, França
- CHU de Toulouse
-
Contato:
- Laure CONNAN
- Número de telefone: 5 67 77 12 33
- E-mail: connan.l@chu-toulouse.fr
-
-
Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Número de grupos/coortes
Coortes e Intervenções
Grupo / CoorteGrupo / Coorte |
Intervenção / TratamentoIntervenção / Tratamento |
|---|---|
|
Women with HG
|
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
|
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
|
O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Prazo |
|---|---|
|
Area under the curve for the FRENCH HELP score to diagnose hyperemesis gravidarum
Prazo: Month 21
|
Month 21
|
|
Area under the curve for the PUQE score to diagnose hyperemesis gravidarum
Prazo: Month 21
|
Month 21
|
Medidas de resultados secundários
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Area under the curve for the FRENCH HELP score to diagnose severe hyperemesis gravidarum
Prazo: Month 21
|
Month 21
|
|
|
Area under the curve for the PUQE score to diagnose severe hyperemesis gravidarum
Prazo: Month 21
|
Month 21
|
|
|
Discordance rate between FRENCH HELP and PUQE
Prazo: 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
Prazo: Month 21
|
percentage (%)
|
Month 21
|
|
Predictive values of FRENCH HELP score on miscarriage
Prazo: Month 21
|
Classed as pregnancy loss before 15 weeks of gestation
|
Month 21
|
|
Predictive values of PUQE score on miscarriage
Prazo: Month 21
|
Classed as pregnancy loss before 15 weeks of gestation
|
Month 21
|
|
Newborn small for gestational age
Prazo: At birth (Max 9 months)
|
Classed as birth weight < 10th percentile
|
At birth (Max 9 months)
|
|
Preterm birth
Prazo: At birth (Max 37 weeks)
|
Classed as delivery before 37 weeks of gestation
|
At birth (Max 37 weeks)
|
|
Gestational hypertension
Prazo: 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
Prazo: Before birth (max Month 9)
|
Classed as gestational hypertension and proteinuria >0.3 g/24 hours
|
Before birth (max Month 9)
|
|
Labor characteristics
Prazo: 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
Prazo: At birth (max month 9)
|
Yes/no
|
At birth (max month 9)
|
|
Birth weight
Prazo: At birth (max 9 months)
|
grams
|
At birth (max 9 months)
|
|
newborn Apgar score < 7
Prazo: At birth (max 9 months)
|
Yes/no
|
At birth (max 9 months)
|
|
Umbilical cord blood pH
Prazo: At birth (max 9 months)
|
At birth (max 9 months)
|
|
|
Umbilical cord blood PCO2
Prazo: At birth (max 9 months)
|
mmHg
|
At birth (max 9 months)
|
|
Umbilical cord blood PO2
Prazo: At birth (max 9 months)
|
mmHg
|
At birth (max 9 months)
|
|
lactate levels in umbilical arterial blood
Prazo: At birth (max 9 months)
|
mmol/L
|
At birth (max 9 months)
|
|
newborns transferred to a neonatal unit
Prazo: At birth (max 9 months)
|
Yes/no
|
At birth (max 9 months)
|
|
presence of a congenital malformation
Prazo: At birth (max 9 months)
|
Yes/no
|
At birth (max 9 months)
|
|
presence of depression
Prazo: 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
Prazo: 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
Prazo: 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
|
Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Stephanie Huberlant, Centre Hospitalier Universitaire de Nîmes
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Início do estudo
Conclusão Primária (Estimado)
Conclusão Primária
Conclusão do estudo (Estimado)
Conclusão do estudo
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Primeira postagem
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última Atualização Postada
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
Outros números de identificação do estudo
- AOI GCS/2025/S
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .