Usability of Pregnancy-Unique Quantification of Emesis questionnaire in women hospitalised for hyperemesis gravidarum: a prospective cohort study

Abstract

ObjectivesPregnancy-Unique Quantification of Emesis (PUQE) questionnaire is mainly used in outpatient care to assess the severity of nausea and vomiting of pregnancy (NVP). Our aim was to evaluate the usability of the Finnish-translated PUQE in hospitalised women with hyperemesis gravidarum (HG).DesignProspective cohort study.SettingUniversity hospital in Finland.ParticipantsNinety-five women admitted due to HG for at least overnight.Primary and secondary outcome measuresCategorised and continuous PUQE scores, physical and mental quality of life (QoL) and urine ketones at admission and at discharge, analysing the first admission and readmissions separately.ResultsThe most common PUQE categories at admission were ‘moderate’ and ‘severe’, whereas at discharge they were ‘mild’ and ‘moderate’. Likewise, continuous PUQE scores improved between admission and discharge (p<0.0001). At admission, women rating worse physical QoL (first admission adjusted OR (AOR) 1.09; 95% CI 1.03 to 1.16; readmissions AOR 1.13; 95% CI 1.02 to 1.25) and women with ketonuria of +++ (first admission AOR 16.00; 95% CI 1.44 to 177.82) fell into higher PUQE score category. On discharge day, women with better physical QoL had lower PUQE score category (first admission AOR 0.94; 95% CI 0.91 to 0.98; readmissions AOR 0.93; 95% CI 0.90 to 0.97). The results between physical QoL and continuous PUQE scores were similar. Concerning readmissions, better mental QoL was associated with lower PUQE score category at discharge (AOR 0.93; 95% CI 0.89 to 0.97). As for continuous PUQE score, worse mental QoL was associated with higher score at admission (readmissions, p=0.007) and better mental QoL with lower score at discharge (readmissions, p=0.007).ConclusionsPUQE scores reflected alleviation of NVP severity in women hospitalised due to HG. Further, the decrease in PUQE score was associated with improved physical QoL and partly also with improved mental QoL. We therefore suggest PUQE as a complementary instrument for inpatient setting.

Use of the Modified Pregnancy -Unique Quantification of Emesis Score to Evaluate the Need for Admission and Response to Treatment in women with Hyperemesis Gravidarum

“…The fact that the PUQE score was useful in guiding the need for admission and discharge agrees with previous reports. Three previous studies (1,10,11) showed improved PUQE scores after treatment (10). Moreover, a correlation was established between elevated PUQE scores, inadequate dietary and diminished general well-being (10).…”

“…Those were excluded for the following reasons: 15 cases were diagnosed as gastritis and peptic ulcer documented by upper endoscopy, 8 cases had pyelonephritis,7 cases were diagnosed as Thyrotoxicosis, 5 cases had undiagnosed diabetes mellitus with diabetic ketoacidosis and 10 cases had a miscalculation with a gestational age above 16 weeks (figure 1). Table [1] includes a summary of the baseline characteristics of the study group.…”

“…Nausea and vomiting of pregnancy (NVP) impacts as many as 80% of pregnant females (1). Nausea and vomiting during pregnancy (NVP) exhibit a wide range of severity levels, spanning from mild, sporadic nausea to severe, uncontrollable vomiting that necessitates medical attention at the hospital (2).…”

Developing the quality of life in pregnancy scale (PREG-QOL)

“…Scoring system was based on the calculation of mean scores for each factor, which ranged from 1 to 5. Items 11,12,13,14,15,16,19,20,21,22,23,25 and 26 were reverse-scored. Total score was not calculated.…”

“…The majority of the studies on the HRQOL in pregnant women mostly include only general psychometric properties [14][15][16][17][18][19][20][21][22] or focus on speci c problems during pregnancy [25]. Evaluation of the period-speci c HRQOL has become more important to investigate the effectiveness or preventive and therapeutic programs developed for women in pregnancy and postpartum periods.…”