HyperEmesis Level Prediction (HELP) Score Assessment

Wondering how severe your HG is? Take this validated scoring tool. Mild or severe, you are no doubt very miserable. Your score will reflect the severity of your hyperemesis gravidarum, or severe nausea and vomiting during pregnancy (pregnancy sickness). SEE BELOW FOR MORE DETAILS ON UNDERSTANDING YOUR SCORE.

  • 0 (None)1 (Mild)23 (Moderate)45 (Severe)
  • 01-23-56-89-1213 or more
  • 01-23-56-89-1213 or more
  • SameMore often due to IV fluids; light colorSlightly less often, and normal colorOnce every 8 hours; slightly dark yellowLess than every 8 hours or darkerRarely; dark, blood; foul smell
  • 0 (None)1 (Mild)23 (Moderate)45 (Severe)
  • 01-2 (hours are slightly less)3-4 (can work part time)5-7 (can only do a little work)8-10 (can’t care for family)11+ (can’t care for myself)
  • NormalTired but mood is okSlightly less than normalIt’s tolerable but difficultStruggling: moody, emotionalPoorly: irritable depressed
  • Same; no weight lossTotal of about 3 meals & 6+ cups fluidTotal of about 2 meals & some fluids1 meal & few cups fluid; only fluid or only foodVery little, <1 meal/minimal fluids; or frequent IVNothing goes or stays down, or daily IV/TPN/NG
  • No medsAlwaysNearly AlwaysSometimesRarelyNever/IV/SQ (subQ pump)
  • GreatBetterAbout SameWorseMuch WorseSo Much Worse
  • 0%1%2%3%4%5%
    Estimate or use our weight loss calculator to determine amount lost over the LAST 7 days. Weight loss calculator: www.hyperemesis.org/weight-loss-calculator/
  • 012345+
    Each medication for vomiting is 1 point. Zofran + Phenergan + IV fluids = 3


Nausea and vomiting in pregnancy are on a spectrum from mild which is morning sickness to severe which is hyperemesis gravidarum (HG). Unlike those with morning sickness, women with HG generally have inadequate food or fluid much of the time, and cannot do many of their normal activities most days. HG is not severe morning sickness but a separate diagnosis which requires medical care to avoid progressing to the next level of severity. Every woman with HG suffers greatly, and often is unable to do their normal activities and struggles to eat and drink. Compassionate support, both practical and medical, is critical no matter how mild or severe their HG is.

Mild usually implies a woman is very unwell and usually is unable to eat her normal amount and struggling to function but may be able to do some activities, Support and medical care may prevent progression to more severe symptoms.

Moderate cases usually are unable to eat/drink normally or do most of their usual activities. They may be unable to care for their family and even themselves and require extra rest. Complications affecting both mother and child may occur if not adequately treated. Coping will be even more difficult and mental health support is likely needed to reduce the trauma. Aggressive intervention is needed for moderate to severe cases, including vitamin supplementation, especially B1.

Severe cases are most at risk of serious complications for mother and child, especially if malnutrition continues beyond the first trimester. Exhaustion is universal and they may be unable to even care for themselves. Rest is critical to avoid worsening HG. Depression, anxiety, and trauma are extremely common.

Postpartum complications are more likely to develop as symptom severity increases and when symptoms are prolonged or uncontrolled.

HELP (HyperEmesis Level Prediction) Score

The HyperEmesis Level Prediction Score was developed by the HER Foundation to quantify HG symptoms into a score that can be trended over time to monitor progress and response to treatment. Download the free HG Care App to automatically calculate your HELP Score, track your treatments, and alert you to concerning changes in your symptoms.

  • Scores below 20 indicate either no HG (morning sickness) or mild HG.
  • Scores between 20 - 32 indicate symptoms are in the moderate range.
  • Scores between 33 - 60 indicate severe symptoms that need aggressive care.
HyperEmesis Level Prediction Score