The roll-over test as a screening procedure for gestational hypertension

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Diagnostics

Background:

• Gestational hypertension is a significant concern in pregnancy.
• Early detection of gestational hypertension is crucial for maternal and fetal well-being.
• The roll-over test has been proposed as a screening tool for this condition.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the roll-over test in identifying pregnant women at risk of developing gestational hypertension.
• To assess the reliability, sensitivity, and specificity of the roll-over test in a primigravidae population.

Main Methods:

• One hundred and ninety-one primigravidae underwent two roll-over tests between 28 and 34 weeks of gestation.
• Participants were monitored for the development of hypertension.
• Test results were compared against the actual development of gestational hypertension.

Main Results:

• The roll-over test identified a low percentage of women who later developed hypertension (44% and 42% in two tests).
• A significant number of normotensive women received positive or negative results, indicating poor specificity and sensitivity.
• No significant difference in diastolic pressure increase was observed between women who did and did not develop hypertension.

Conclusions:

• The roll-over test demonstrates insufficient reliability, sensitivity, and specificity for effective clinical screening of gestational hypertension.
• Current evidence suggests the roll-over test is not a suitable tool for routine use in antenatal care for predicting gestational hypertension.