Hyperemesis Gravidarum Treatment SurveyHyperemesis Gravidarum Treatment Survey

This questionnaire is intended to evaluate the effectiveness of pharmacological and non pharmacological treatments for Hyperemesis Gravidarum as part of an independent study of the condition. All of the information that you provide will be anonymous.

1. Are you currently suffering or have you previously suffered from Hyperemesis Gravidarum?

Are you currently suffering or have you previously suffered from Hyperemesis Gravidarum? Yes

2. Was this diagnosis confirmed by a medical professional?

Was this diagnosis confirmed by a medical professional? Yes

3. Have you required in-patient hospital treatment for your symptoms at any stage?

Have you required in-patient hospital treatment for your symptoms at any stage? Yes

4. Please rate the effectiveness of all of the following pharmacological treatments that you have tried (if any):

	Not effective	Slightly effective	Effective	Very Effective	N/A
Anti-emetics (anti-sickness drugs such as metaclopramide or cyclizine)	*Please rate the effectiveness of all of the following pharmacological treatments that you have tried (if any): Anti-emetics (anti-sickness drugs such as metaclopramide or cyclizine) Not effective	Anti-emetics (anti-sickness drugs such as metaclopramide or cyclizine) Slightly effective	Anti-emetics (anti-sickness drugs such as metaclopramide or cyclizine) Effective	Anti-emetics (anti-sickness drugs such as metaclopramide or cyclizine) Very Effective	Anti-emetics (anti-sickness drugs such as metaclopramide or cyclizine) N/A
Antihistamines	Antihistamines Not effective	Antihistamines Slightly effective	Antihistamines Effective	Antihistamines Very Effective	Antihistamines N/A
Vitamin B12 supplements	Vitamin B12 supplements Not effective	Vitamin B12 supplements Slightly effective	Vitamin B12 supplements Effective	Vitamin B12 supplements Very Effective	Vitamin B12 supplements N/A
Vitamin B6 supplements	Vitamin B6 supplements Not effective	Vitamin B6 supplements Slightly effective	Vitamin B6 supplements Effective	Vitamin B6 supplements Very Effective	Vitamin B6 supplements N/A
Phenothiazines	Phenothiazines Not effective	Phenothiazines Slightly effective	Phenothiazines Effective	Phenothiazines Very Effective	Phenothiazines N/A
Steroids	Steroids Not effective	Steroids Slightly effective	Steroids Effective	Steroids Very Effective	Steroids N/A

5. Please rate the effectiveness of all of the non pharmacological treatments that you have tried (if any):

	Not effective	Slightly effective	Effective	Very effective	N/A
Ginger	*Please rate the effectiveness of all of the non pharmacological treatments that you have tried (if any): Ginger Not effective	Ginger Slightly effective	Ginger Effective	Ginger Very effective	Ginger N/A
Accupressure	Accupressure Not effective	Accupressure Slightly effective	Accupressure Effective	Accupressure Very effective	Accupressure N/A
Accupuncture	Accupuncture Not effective	Accupuncture Slightly effective	Accupuncture Effective	Accupuncture Very effective	Accupuncture N/A
Controlled diet (such as high carbohydrate/ low fat/ caffeine free)	Controlled diet (such as high carbohydrate/ low fat/ caffeine free) Not effective	Controlled diet (such as high carbohydrate/ low fat/ caffeine free) Slightly effective	Controlled diet (such as high carbohydrate/ low fat/ caffeine free) Effective	Controlled diet (such as high carbohydrate/ low fat/ caffeine free) Very effective	Controlled diet (such as high carbohydrate/ low fat/ caffeine free) N/A
Peppermint	Peppermint Not effective	Peppermint Slightly effective	Peppermint Effective	Peppermint Very effective	Peppermint N/A
Complementary therapies (such as homeopathy, hypnotherapy and reflexology)	Complementary therapies (such as homeopathy, hypnotherapy and reflexology) Not effective	Complementary therapies (such as homeopathy, hypnotherapy and reflexology) Slightly effective	Complementary therapies (such as homeopathy, hypnotherapy and reflexology) Effective	Complementary therapies (such as homeopathy, hypnotherapy and reflexology) Very effective	Complementary therapies (such as homeopathy, hypnotherapy and reflexology) N/A

Many thanks for taking the time to complete this questionnaire. If you are interested in seeing the results of the study then please do not hesitate to contact me at beccaboo1801@gmail.com.

6. Please use this area to leave any comments that you would like to make.

Please use this area to leave any comments that you would like to make.

Hyperemesis Gravidarum Treatment Survey
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Hyperemesis Gravidarum Treatment Survey
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