Roll-Over Test as Predictive Value of Pre-eclampsia / La Prueba de Roll-Over Como Predictor de Pre-eclampsia

ABSTRACT Objective: To determine the effectiveness of the roll-over test as a predictor of pre-eclampsia. Methodology: The studied population had a size of 272, with a sample of 262 pregnant women, between 28 and 32 weeks of gestational age, who obtained pre-natal care at the Guillermo Almenara Irigoyen National Hospital, between January and September of 2017. The ROC curve, and the sensitivity and specificity of the roll-over test to predict pre-eclampsia, were calculated. Results: The prevalence of the roll-over test in this study was 9%, with a 95% confidence interval (5.43 - 12.22). In this study, the ROC curve was determined (0.725 and 0.734, for the first and second measurements, respectively) and found to be statistically significant at the p <0.05 level. The sensitivity of the roll-over test for a cutoff point of 20 mmHg was 60%, and the specificity of 95% also had a PPV of 37% and a NPV of 98%. Differences between the first and second measurements suggest that the second measurement is more sensitive than the first one. Conclusions: The roll-over test is a simple, cost-effective test with potential application in initial evaluation of pre-eclampsia in pregnant women with a history of pre-eclampsia and/ or other risk factors.

RESUMEN Objetivo: determinar la efectividad de la prueba de presión supina como predictor de pre-eclampsia. Metodología: La población del estudio fue de 272 y la muestra consistió en 262 mujeres embarazadas entre 28 y 32 semanas de edad gestacional que obtuvieron atención prenatal en el Hospital Nacional Guillermo Almenara Irigoyen entre enero y septiembre de 2017. Se realizó la curva ROC y se calculó la sensibilidad y la especificidad de la prueba de vuelco para predecir la pre-eclampsia. Resultados: La prevalencia de la prueba de presión supina en este estudio fue del 9% con un intervalo de confianza del 95% (5,43 - 12,22). En este estudio, se determinó la curva ROC (0,725 y 0,734 para la primera y la segunda medición respectivamente) y se encontró que era estadísticamente significativa al nivel de p <0,05. La sensibilidad de la prueba de presión supina para un punto de corte de 20 mmHg fue del 60% y la especificidad del 95% también tuvo un VPP del 38% y un VPN del 98%. Las diferencias entre la primera y la segunda medición sugieren que la segunda medición es más sensible que la primera. Conclusiones: la prueba de presión supina es una prueba simple y rentable con una posible aplicación en la evaluación inicial de la pre-eclampsia en mujeres embarazadas con antecedentes o pre-eclampsia y / u otros factores de riesgo.

Validity study of the roll-over test and risk factors for Preeclampsia in four health districts of Surigao City, Philippines

Background@#The roll-over test is a simple, easily available clinical test using the sphygmomanometer to predict pregnancy-induced hypertension starting at 20 weeks age of gestation (AOG). However, the roll-over test is not part of the standard prenatal care in government health facilities even if health workers can easily perform the test.@*Objectives@#To validate the roll-over test at the 20th weeks of gestation and to determine the risk factors for preeclampsia in 4 health districts of Surigao City, a province in the CARAGA Region of the Philippines.@*Methods@#A total of 190 pregnant women without history of hypertension during their previous pregnancies from 4 health districts in Surigao City, Philippines were consecutively enrolled from May 2014 to October 2014 in a cross-sectional study design. The roll-over test was done using the method described in Williams Obstetrics and the validity of the roll-over test was measured. Bivariate and multivariate analyses were done to determine risk factors for preeclampsia.@*Results@#Seven of the 190 women developed preeclampsia. The sensitivity of the rollover test done at 20 weeks AOG was 43% and the specificity was 81%. Maternal age, history of urinary tract infection (UTI) and a positive roll-over test were associated with preeclampsia.@*Conclusion@#Pregnant women whose ages are <20 years or >29 years old, or who had a history of UTI, or a positive roll-over test are more likely to develop preeclampsia. Roll-over test has a low sensitivity at 20 weeks AOG. More studies are warranted to explore the improvement of its predictive value in other AOG.

Teh Predictive Value of Serum Fibronectin and Roll-over Test for Pregnancy Induced Hypertension / 대한주산의학회잡지

To evaluate the predictive value of serum fibronectin and roll-over test for pregnancy induced hypertension (PIH), we studies 79 patients between the twenty-eighth and thirty-second week of gestation from October 1995 to May 1996. The results were as follows . 1) There was no significant difference of mean diastolic pressure difference in roll-over test and serum fibronectin levels between 13 PIH patients and 66 controls. Between two groups of patients, mean diastolic blood pressure differences were 14.3+/-3.9mmHg, 12.0+/-4.4mmHg and mean serum fibronectin levels were 231.2+/-90.8 pg/ml, 196.5+/-61.2 pg/ml respectively(p> 0.1). 2) For prediction of PIH, the sensitivity, the positive predictive value and the negative predictive value of roll-over test were 8%, 14% and 83%.