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HG Self-Assessment

HG Self-Assessment

This quick self-assessment is designed for patients with severe nausea and vomiting in pregnancy. It helps summarize symptom burden and can be repeated to track change over time. It is not a diagnosis.

1. How severe is your nausea today?
2. How many times have you vomited in the last 24 hours?
3. How many times have you retched or nearly vomited in the last 24 hours?
4. How much fluid and food can you keep down?
5. How often are you urinating compared with normal?
6. How much has HG limited your normal activities today?
7. How was your sleep in the last 24 hours?
8. How severe is excessive salivation (ptyalism) today?
9. How are you feeling emotionally today?
10. Compared with yesterday, your HG symptoms are:
Optional details



If you cannot keep fluids down, are urinating very little, feel faint/confused, or have thoughts of self-harm, seek urgent medical care.

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