Prepare for your next appointment and assess your symptoms

Pregnancy can be a difficult time. Nausea and Vomiting of Pregnancy often causes further anxiety. However, talking to your doctor and nurse can help, so you should consider raising how severe your nausea and vomiting is and how it’s affecting you at your next appointment.

It is important to be open about how you are feeling to get the support you need and know that your doctor or nurse will treat your information with confidence.

How can I assess my Nausea and Vomiting of Pregnancy symptoms?

You might find it useful to assess the severity of your Nausea and Vomiting of Pregnancy, which you may know as morning sickness. It has been found that women who keep a diary will be able to provide more accurate information, which will really help your doctor or nurse identify how best to help you.

A useful tool is the Pregnancy Unique Quantification of Emesis symptom score (PUQE score) which has been developed to help women track their symptoms and uses just three simple questions. Using this every day can help you calculate your PUQE score.

The PUQE symptom score is a measure of how severe your Nausea and Vomiting of Pregnancy symptoms are and helps your doctor or nurse better understand how this is affecting your life.

The three questions to ask yourself each day are:

  1. In the last 24 hours for how long have you felt nauseated or sick to your stomach?
  2. In the last 24 hours have you vomited or thrown up?
  3. In the last 24 hours how many times have you had retching or dry heaves without bringing anything up?

Below is a table which shows the point value for each answer. If you add your points up for each day, you can see what your daily PUQE score is and if it is changing during your pregnancy.

Question Point value for responses Total
  1. In the last 24 hours for how long have you felt nauseated or sick to your stomach?
Not at all (1) 1 hour or less (2) 2-3 hours (3) 4-6 hours (4) More than 6 hours (5) Score out of 5 (1-5)?
  1. In the last 24 hours have you vomited or thrown up?
I did not throw up (1) 1-2 times (2) 3-4 times (3) 5-6 times (4) 7 or more times (5) Score out of 5 (1-5)?
  1. In the last 24 hours how many times have you had retching or dry heaves without bringing anything up?
No times (1) 1-2 times (2) 3-4 times (3) 5-6 times (4) 7 or more times (5) Score out of 5 (1-5)?
Sum of point values for the three questions to find the PUQE score: Total score out of 15?

The total score will give an indication of how severe your nausea and vomiting of pregnancy is:

Total PUQE score ≤6 7-12 13-15
Severity of nausea and vomiting of pregnancy Mild Moderate Severe

This is not a diagnosis. Please discuss how you are feeling and your symptoms with your healthcare professional.

How should I prepare for my next appointment?

Your appointment is a chance to tell your doctor or nurse how you are feeling, but there will be lots to discuss. As a result, it is very easy to forget what these all are – you may find it useful to prepare beforehand to make sure that you use the time as effectively as possible:

  • Write a list of the topics you would like to discuss with your doctor or nurse
  • You could use your PUQE symptom score results to discuss your symptoms with them
  • Write down anything you have tried to reduce your symptoms – did it work for you?

How should I discuss my symptoms with my doctor or nurse?

It is important that you are open with your doctor or nurse about how you are feeling and ask any questions if you are unsure. This will ensure that you can make a decision together about the best way for you to manage your Nausea and Vomiting of Pregnancy symptoms.

  • Has the severity of your symptoms improved / worsened / stayed the same?
  • Are your symptoms affecting your day-to-day life and, if so, how?
  • What have you done so far to improve your Nausea and Vomiting of Pregnancy? Is this working for you and has there been a reduction in your PUQE symptom score?
  • If it hasn’t been working, if needed, what else could you try to reduce your symptoms?

It is also recommended that you use open questions to help you make the most of the 5-10 minutes that you will have with your doctor or nurse. These types of questions cannot be answered with yes or no. For example:

OPEN

  • What can I do to improve my Nausea and Vomiting of Pregnancy?
  • What natural remedies can I take?
  • Are there any recommended medicines that could help?
  • What are the side effects of treatment?

CLOSED

  • Is there anything I can do to improve my condition?
  • Does this treatment have side effects?