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PUQE Score Calculator (Nausea and Vomiting in Pregnancy)

Score the severity of nausea and vomiting in pregnancy over the last 24 hours with the PUQE-24 scale (mild, moderate or severe) and see when to talk to your doctor about hyperemesis.

In the last 24 hours, how long have you felt nauseated?

In the last 24 hours, how many times have you vomited?

In the last 24 hours, how many times have you had retching or dry heaves without bringing anything up?

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How it works

PUQE-24 = nausea points (1–5) + vomiting points (1–5) + retching points (1–5), range 3–15 · ≤ 6 mild, 7–11 moderate, ≥ 12 severe

The Pregnancy-Unique Quantification of Emesis (PUQE) score was developed by Koren and colleagues (2002) and adapted to cover the previous 24 hours (PUQE-24). Three questions — hours of nausea, number of vomiting episodes and number of retching episodes — are each scored 1 to 5. The UK Royal College of Obstetricians and Gynaecologists recommends it to grade nausea and vomiting of pregnancy and to follow the response to treatment; a score of 12 or more, or any sign of dehydration or weight loss, suggests hyperemesis gravidarum.

Worked example

Nausea for 4–6 hours (4 points), vomiting 1–2 times (2 points) and retching 1–2 times (2 points): PUQE-24 = 4 + 2 + 2 = 8 / 15, which is Moderate nausea and vomiting — talk to your doctor about anti-sickness medicine.

Sources: Koren G et al. (2002) Motherisk-PUQE scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 186(5 Suppl):S228–231 · RCOG Green-top Guideline No. 69: Management of nausea and vomiting of pregnancy and hyperemesis gravidarum (2016, updated 2024)

Frequently asked questions

What is a normal PUQE score?

There is no “normal” score, but 3–6 is mild nausea and vomiting, which most pregnant people experience at some point. Scores of 7–11 are moderate and 12–15 severe.

What is hyperemesis gravidarum?

A severe form of pregnancy sickness with persistent vomiting, weight loss of more than 5% of pre-pregnancy weight, dehydration and electrolyte problems. It often needs medicine, intravenous fluids and sometimes hospital care.

When should I see a doctor for vomiting in pregnancy?

Seek care the same day if you cannot keep fluids down for 24 hours, pass very little dark urine, feel dizzy or faint, vomit blood, have abdominal pain or fever, or your PUQE score is 12 or more.

What helps with pregnancy nausea?

Small, frequent, bland meals, avoiding triggers, rest, ginger and acupressure may help mild symptoms. For moderate or severe nausea, safe medicines such as pyridoxine–doxylamine or antiemetics prescribed by your doctor are effective.

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This calculator is for education only and does not replace your midwife, obstetrician or doctor. Contact your care team straight away about bleeding, fluid leaking, reduced baby movements, severe pain, fever or anything that worries you.