PUQE Score Calculator – Check Morning Sickness Severity (PUQE-24)

PUQE Score Calculator – Nausea and Vomiting in Pregnancy Assessment Tool

PUQE-24 Score Calculator

Answer these three questions about your symptoms in the last 24 hours to calculate your pregnancy nausea and vomiting score.

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?
Optional How would you rate your overall wellbeing in the last 24 hours?

0 = worst possible, 10 = how you felt before pregnancy. This does not affect your PUQE score.

0 5 10

How the PUQE Score Works

The PUQE score (Pregnancy-Unique Quantification of Emesis and Nausea) is a validated pregnancy nausea and vomiting assessment tool. Originally developed as the Motherisk PUQE-24, it helps classify the severity of nausea and vomiting of pregnancy (NVP), commonly known as morning sickness.

Understanding Your Score

The PUQE-24 score ranges from 3 to 15 based on three questions about your symptoms in the last 24 hours:

  • 3–6: Mild NVP – Symptoms are present but manageable with self-care measures.
  • 7–12: Moderate NVP – Symptoms are more disruptive and may benefit from treatment.
  • 13–15: Severe NVP – Symptoms are significant and may indicate hyperemesis gravidarum, requiring medical attention.

About Hyperemesis Gravidarum

Hyperemesis gravidarum (HG) is a severe form of pregnancy sickness that goes beyond typical morning sickness. It can cause dehydration, weight loss, and difficulty keeping down food or fluids. If you have a high PUQE score or are struggling to stay hydrated, please seek medical advice promptly. The RCOG Green-top Guideline 69 provides clinical guidance on managing this condition.

Track Your Symptoms Over Time

You can use this PUQE score calculator to monitor your pregnancy nausea and vomiting over time. Tracking your scores can help you and your healthcare provider understand whether your symptoms are improving, staying the same, or getting worse. Your recent scores are stored locally on your device for easy reference.

Frequently Asked Questions

What is the PUQE score?

The PUQE score (Pregnancy-Unique Quantification of Emesis and Nausea) is a validated scoring system used to assess the severity of nausea and vomiting during pregnancy. It was originally developed by Motherisk and is now widely used in clinical settings, including by the NHS, to help classify morning sickness as mild, moderate, or severe.

What is a normal PUQE score?

PUQE scores range from 3 to 15. A score of 3–6 indicates mild nausea and vomiting, which is common in early pregnancy. Scores of 7–12 suggest moderate symptoms, while 13–15 indicates severe symptoms. There is no single "normal" score, as many pregnant people experience some degree of nausea, but lower scores generally indicate milder symptoms.

Does a high PUQE score mean I have hyperemesis gravidarum?

A high PUQE score (13–15) suggests severe nausea and vomiting of pregnancy, which may be associated with hyperemesis gravidarum (HG). However, the PUQE score alone does not diagnose HG. Hyperemesis gravidarum is typically diagnosed by healthcare professionals based on symptoms including severe vomiting, dehydration, ketones in urine, and weight loss. If you have a high score, please speak to your midwife or GP for proper assessment.

When should I see a doctor or midwife about my morning sickness?

You should contact your midwife, GP, or maternity unit if: you cannot keep any food or fluids down for more than 24 hours; you have signs of dehydration (dark urine, dizziness, dry mouth); you have lost weight; your vomit contains blood; you have severe abdominal pain; or your symptoms are significantly affecting your daily life. A moderate or high PUQE score is also a good reason to seek advice about treatment options.

Can I use this PUQE score calculator to monitor my symptoms over time?

Yes, this online PUQE score test allows you to track your pregnancy nausea score over time. Your recent results are saved locally on your device, so you can see whether your symptoms are improving or worsening. This information can be helpful when discussing your care with your midwife or GP.

Is the PUQE score recognised in clinical guidelines?

Yes, the PUQE score is referenced in clinical guidelines for managing nausea and vomiting of pregnancy. In the UK, the RCOG Green-top Guideline 69 on the management of nausea and vomiting of pregnancy and hyperemesis gravidarum acknowledges PUQE as a tool for assessing symptom severity. It is widely used by healthcare professionals including midwives, GPs, and hospital teams.

Is this PUQE calculator suitable for use in the UK?

Yes, this pregnancy sickness score calculator is designed for UK users. The advice provided references NHS services including your midwife, GP, and NHS 111. The PUQE-24 scoring system is used in UK clinical practice and aligns with nausea and vomiting of pregnancy guidelines followed in the NHS.

What is the difference between PUQE and PUQE-24?

PUQE-24 refers to the version of the Pregnancy-Unique Quantification of Emesis and Nausea questionnaire that asks about symptoms over the past 24 hours. This is the most commonly used version and is what this calculator uses. There is also a modified version that asks about a longer time period, but the 24-hour version is standard in most clinical settings.