La Prueba de Roll-Over Como Predictor de Pre-eclampsia.

Jorge Torres-Coronado,Jenette Smith,Jhony A De La Cruz-Vargas,Miguel A Pérez,Maria Loo-Valverde

doi:10.14482/sun.37.2.618.361

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-eclamp-sia, 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 be-tween 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.

Highlights

Hypertensive disorders during pregnancy, including pre-eclampsia and eclampsia, affect some ten million women, or roughly 5 to 10% of pregnant women worldwide [1], and can result in maternal death in 10-25% of the cases
Pre-eclampsia is associated with high levels of maternal mortality, and impacts fetal and infantile mortality, especially if it is complicated with eclampsia, or in some cases, Hemolysis Elevated Liver Enzymes Low Platelet count (HELLP syndrome), which can affect between 4-12% of those diagnosed with pre-eclampsia, and has a mortality rate as high as 25%(6)
Results from this study show that 100% of pregnant women, with a history of pre-eclampsia, had a positive roll-over test

Summary

Introduction

Hypertensive disorders during pregnancy, including pre-eclampsia and eclampsia, affect some ten million women, or roughly 5 to 10% of pregnant women worldwide [1], and can result in maternal death in 10-25% of the cases These rates are not uniform around the world, with data showing that, in low-income countries, pregnant women are seven times more likely to develop pre-eclampsia than women in high-income countries [2,3,4,5,6]. Given high morbidity and mortality factors, it is important to predict if a pregnant woman will develop pre-eclampsia and to proactively treat each patient in a timely manner to avoid complications. This is important in low- and middle-income countries, where reducing the rates of pre-eclampsia and HELLP syndrome may decrease maternal and infant morbidity and mortality rates

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Results

Discussion

Conclusion