Koren Gideon, Boskovic Radinka, Hard Marjie, Maltepe Caroline, Navioz Yvette, Einarson Adrienne
Motherisk Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
Am J Obstet Gynecol. 2002 May;186(5 Suppl Understanding):S228-31. doi: 10.1067/mob.2002.123054.
The morbidity of nausea and vomiting of pregnancy varies substantially. In addition to the physical symptoms, the emotional and psychosocial stress must be considered. The method available today to measure the severity of nausea and vomiting of pregnancy stems from chemotherapy-induced symptoms and is too complicated to use clinically. We sought to establish a simple and clinically relevant method for evaluation of the severity of nausea and vomiting of pregnancy that can be used for both clinical practice and research.
Women with nausea and vomiting of pregnancy were scored by use of the "gold standard" Rhodes' score, which includes 8 items. The Rhodes' score was compared with several short versions of 3 to 4 items. Patients were subsequently followed up a week later to monitor changes in scores. Changes in the Rhodes' scores were correlated with changes in the simplified scores.
There was a very tight correlation between the Rhodes' score and the new pregnancy-unique quantification of emesis and nausea (PUQE) scoring system, which was based on the 3 items that included the number of daily vomiting episodes, the length of nausea per day in hours, and the number of retching episodes (r = 0.904; P <.0001). The distribution of severity of cases (between none, mild, moderate, and severe) did not differ between the Rhodes' and the PUQE. Comparing the changes in Rhodes' scores after a week of follow-up versus changes in the new PUQE score, there was a very high agreement (r = 0.95;P <.0001).
The new PUQE score yields similar results to the gold standard, but more cumbersome, Rhode's score. Clinicians and researchers can easily use PUQE.
妊娠恶心和呕吐的发病率差异很大。除了身体症状外，还必须考虑情绪和社会心理压力。目前可用的测量妊娠恶心和呕吐严重程度的方法源自化疗引起的症状，在临床上使用过于复杂。我们试图建立一种简单且与临床相关的方法来评估妊娠恶心和呕吐的严重程度，该方法可用于临床实践和研究。
使用包括8项内容的“金标准”罗兹评分对妊娠恶心和呕吐的女性进行评分。将罗兹评分与几个包含3至4项内容的简短版本进行比较。随后在一周后对患者进行随访，以监测评分变化。罗兹评分的变化与简化评分的变化相关。
罗兹评分与新的妊娠特异性呕吐和恶心量化（PUQE）评分系统之间存在非常紧密的相关性，该系统基于3项内容，包括每日呕吐发作次数、每天恶心持续时间（以小时计）和干呕发作次数（r = 0.904；P <.0001）。罗兹评分和PUQE评分在病例严重程度分布（无、轻度、中度和重度之间）上没有差异。比较随访一周后罗兹评分的变化与新的PUQE评分的变化，一致性非常高（r = 0.95；P <.0001）。
新的PUQE评分产生的结果与金标准、但更繁琐的罗兹评分相似。临床医生和研究人员可以轻松使用PUQE。
