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

11 augusti 2026 uppdaterad av: 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.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Studietyp

Observationell

Inskrivning (Beräknad)

300

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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

Beskrivning

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.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / Behandling
Women with HG
Övrig: 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
Övrig: 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

Vad mäter studien?

Primära resultatmått

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

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Area under the curve for the FRENCH HELP score to diagnose severe hyperemesis gravidarum
Tidsram: Month 21
Month 21
Area under the curve for the PUQE score to diagnose severe hyperemesis gravidarum
Tidsram: Month 21
Month 21
Discordance rate between FRENCH HELP and PUQE
Tidsram: 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
Tidsram: Month 21
percentage (%)
Month 21
Predictive values of FRENCH HELP score on miscarriage
Tidsram: Month 21
Classed as pregnancy loss before 15 weeks of gestation
Month 21
Predictive values of PUQE score on miscarriage
Tidsram: Month 21
Classed as pregnancy loss before 15 weeks of gestation
Month 21
Newborn small for gestational age
Tidsram: At birth (Max 9 months)
Classed as birth weight < 10th percentile
At birth (Max 9 months)
Preterm birth
Tidsram: At birth (Max 37 weeks)
Classed as delivery before 37 weeks of gestation
At birth (Max 37 weeks)
Gestational hypertension
Tidsram: 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
Tidsram: Before birth (max Month 9)
Classed as gestational hypertension and proteinuria >0.3 g/24 hours
Before birth (max Month 9)
Labor characteristics
Tidsram: 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
Tidsram: At birth (max month 9)
Yes/no
At birth (max month 9)
Birth weight
Tidsram: At birth (max 9 months)
grams
At birth (max 9 months)
newborn Apgar score < 7
Tidsram: At birth (max 9 months)
Yes/no
At birth (max 9 months)
Umbilical cord blood pH
Tidsram: At birth (max 9 months)
At birth (max 9 months)
Umbilical cord blood PCO2
Tidsram: At birth (max 9 months)
mmHg
At birth (max 9 months)
Umbilical cord blood PO2
Tidsram: At birth (max 9 months)
mmHg
At birth (max 9 months)
lactate levels in umbilical arterial blood
Tidsram: At birth (max 9 months)
mmol/L
At birth (max 9 months)
newborns transferred to a neonatal unit
Tidsram: At birth (max 9 months)
Yes/no
At birth (max 9 months)
presence of a congenital malformation
Tidsram: At birth (max 9 months)
Yes/no
At birth (max 9 months)
presence of depression
Tidsram: 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
Tidsram: 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
Tidsram: 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

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Centre Hospitalier Universitaire de Nīmes

Utredare

  • Huvudutredare: Stephanie Huberlant, Centre Hospitalier Universitaire de Nîmes

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 augusti 2026

Primärt slutförande (Beräknad)

1 november 2028

Avslutad studie (Beräknad)

1 november 2028

Studieregistreringsdatum

Först inskickad

11 augusti 2026

Först inskickad som uppfyllde QC-kriterierna

11 augusti 2026

Första postat (Faktisk)

17 augusti 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

17 augusti 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

11 augusti 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • AOI GCS/2025/S

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