Prediction of pregnancy-induced hypertension in primigravidas.
Creators: name: Trombold, Janna S.
Publisher: name: University of Utah
Year: 2012
Subjects: Demographic
Etiology

description: The investigation addressed the problem of prediction of pregnancy-induced hypertension in primigravid women with two forms of the roll over test.  Specifically, this study sought in answer to the following question:  What is the relationship between results of the standard roll over test and modified roll over test, performed on primigravid women who are between 38 and 32 weeks gestation inclusively, and predication of subsequent development of pregnancy-induced hypertension in these women?  Pregnancy-induced hypertension (PIH) is a pathological condition which develops during gestation most commonly in primigravid women and which contributes to maternal and perinatal morbidity and mortality.  Allegedly the supine pressor test, or roll over test, can aid in identifying those women destined to develop PIH.  This investigation sought to clarify the roll over tests' predicative capacities for PIH and to examine time requirements for the standard form of the roll over test and a shortened form of the test, or the modified roll over test.  The population sample consisted of primigravid women who were between 28 and 32 weeks gestation and who attended a private obstetrics clinic in the area which offers the services of three obstetrician/gynecologists.  None of the study participants had a history of hypertension, diabetes, renal disease, or seizure disorders.  Non-probability, convenience sampling was employed.  Those women qualifying during a 1 ½ month period from mid-October through December 1979 were invited to participate in the study.  Twenty primigravidas chose to participate.  The roll-over tests were performed once during the participants' routine antepartum clinic visits.  Review of the subjects' obstetrical records following their deliveries completed the data collection.  The roll-over test scores and pregnancy outcomes were analyzed for the 18 remaining subjects.  It was found that the standard roll over test was not predictive of development of pregnancy-induced hypertension in this sample.  Furthermore, the modified roll-over test also failed to serve as a predictor of PIH in this group of subjects. In addition, a considerable number of false negative test were noted in both the standard and modified version which were 70% and 50% respectively, However, there were no false positive test using the modified roll-over test, contrasted to 57% false positive tests with the standard roll-over test.  There was a highly significant difference in time requirements for performance of the two tests.  While the modified roll-over test required only approximately 1 ½ minutes to perform on the average, the standard roll-over test required an average of approximately 23 ½ minutes to perform.  Finally, it is interesting that eight of the 11 subjects, or 73%, within the PIH category experienced transient hypertension rather than the classic syndrome of pre-eclampsia or eclampsia.  Transient hypertension was described as possible representing a mild from of pregnancy-inducted hypertension or an early manifestation of essential hypertension.  A discussion of this finding was included in the data analysis and interpretation, although no attempt was made to determine the exact source of hypertension in these women.