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Does Standing Up Improve the Predictive Value of the Supine Pressor Test for Gestational Hypertension?

From the Department of Obstetrics and Gynecology, Obafemi Awolowo University, Ile-Ife, Nigeria; and the Academic Department of Obstetrics and Gynecology, Royal Free Hospital, London, United Kingdom

Abstract

Fifty-six primigravid women at 28-32 weeks' gestation were studied prospectively to compare the roll-over test with the stand-up pressor test in the prediction of gestational hypertension. Blood pressures were measured in the different positions continuously using an automated machine. Twenty patients developed gestational hypertension; two of these were accurately predicted by roll-over test and six by stand-up pressor test (P<.001). However, there was no significant difference between the tests in the rates of false negatives, specificity, and negative and positive predictive values. Concomitant measurement of blood pressures in the standing position may increase the sensitivity of the rollover test for the prediction of gestational hypertension.