Clinical study assessing the severity of nausea and vomiting of pregnancy using PUQE score and pregnancy outcomes
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20263987Keywords:
Nausea and vomiting of pregnancy, Hyperemesis gravidarum, PUQE score, Fetomaternal outcomesAbstract
Background: Nausea and vomiting of pregnancy (NVP) is a common condition that varies from mild symptoms to severe hyperemesis gravidarum. The Pregnancy-Unique Quantification of Emesis (PUQE) score provides an objective assessment of symptom severity. This study evaluated the severity of NVP using the PUQE score and its association with maternal and fetal outcomes.
Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care hospital attached to a medical college after ethical approval. A total of 130 pregnant women aged 18–40 years with intrauterine pregnancy of less than 22 weeks presenting with nausea and vomiting were enrolled after informed consent. Demographic, obstetric, clinical, laboratory, and ultrasonographic data were recorded. Severity was assessed using the modified PUQE score. Participants were followed until delivery, and maternal and fetal outcomes were evaluated.
Results: Higher PUQE scores correlated with increased risk of maternal complications such as preterm birth, proteinuria, gestational hypertension, and persistent pelvic girdle pain, and hospital admission. Severe cases were also associated with adverse perinatal outcomes, including low birth weight and increased risk of preterm delivery, NICU admission whereas women with mild-to-moderate scores generally had favourable outcomes.
Conclusions: The PUQE score is a simple and effective tool to objectively assess NVP severity. Its use in clinical practice may help identify women at risk of complications, allowing timely interventions that improve maternal health and optimize fetal outcomes.
References
Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: a prospective study of its frequency, intensity, and patterns of change. Am J Obstet Gynecol. 2000;182(4):931-7.
Chortatos A, Haugen M, Iversen PO, Vikanes Å, Magnus P, Veierød MB. Nausea and vomiting in pregnancy: associations with maternal gestational diet and lifestyle factors in the Norwegian Mother and Child Cohort Study. BJOG. 2013;120(13):1642-53.
Chou FH, Lin LL, Cooney AT, Walker LO, Riggs MW. Psychosocial factors related to nausea, vomiting, and fatigue in early pregnancy. J Nurs Scholarsh. 2003;35(2):119-25.
Royal College of Obstetricians and Gynaecologists. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum. Green-top Guideline No. 69. London: RCOG; 2016. Available from: https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/the-management-of-nausea-and-vomiting-of-pregnancy-and-hyperemesis-gravidarum-green-top-guideline-no-69/ Accessed on 5 August 2026.
Verberg MF, Gillott DJ, Al-Fardan N, Grudzinskas JG. Hyperemesis gravidarum, a literature review. Hum Reprod Update. 2005;11(5):527-39.
Goodwin TM. Hyperemesis gravidarum. Clin Obstet Gynecol. 1998;41(3):597-605.
Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol. 2002;186(5 Suppl):S228-31.
Mullin PM, Ching CY, Schoenberg F, MacGibbon K, Romero R, Goodwin TM, et al. Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum. J Matern Fetal Neonatal Med. 2012;25(6):632-6.
McCarthy FP, Lutomski JE, Greene RA. Hyperemesis gravidarum: current perspectives. Int J Womens Health. 2014;6:719-25.
Chortatos A, Haugen M, Iversen PO, Vikanes Å, Eberhard-Gran M, Bjelland EK, et al. Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the Norwegian Mother and Child Cohort Study. BMC Pregnancy Childbirth. 2015;15:138.
Kugahara T, Ohashi K. Characteristics of nausea and vomiting in pregnant Japanese women. Nurs Health Sci. 2006;8(3):179-84.
Masaadeh AH, Mathias PC, Ford BA, Bosch DE. Helicobacter pylori exposure in nausea and vomiting of pregnancy increases risk of preterm delivery. Infect Dis Obstet Gynecol. 2023;2023:6612268.
Hastoy A, Lien Tran P, Lakestani O, Barau G, Gérardin P, Boukerrou M. Hyperemesis gravidarum and pregnancy outcomes. J Gynecol Obstet Biol Reprod (Paris). 2015;44(2):154-63.
Koren G, Piwko C, Ahn E, Boskovic R, Maltepe C, Einarson A, et al. Validation studies of the Pregnancy Unique-Quantification of Emesis (PUQE) scores. J Obstet Gynaecol. 2005;25(3):241-4.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Aditi R. Ramugade, Shweta A. Khade, Vibha S. More

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.