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The roll over test is not of value in predicting pregnancy induced hypertension.
Sebagai prediktor hipertensi kehamilan diinduksi (PIH) gulungan lebih uji (ROT)
telah bertentangan nilai prediktif dalam literatur, mungkin sebagai hasil dari sampel,
komposisi ukuran atau metodologi. Dalam penelitian ini berguling tes dilakukan pada
600 wanita Afrika di kehamilan pertama mereka dan pada 26-32 minggu. Tes positif
pada 15% perempuan dan memiliki nilai prediktif positif hanya 20%. Disimpulkan
bahwa berguling tes adalah tidak ada nilai dalam prediksi PIH.
OBJECTIVE:
To determine the roll-over test (ROT) performance in predicting pregnancy-
induced hypertension (PIH) in primigravidae aged 15-29 years in a public primary
care service.
METHOD:
Prospective cohort study enrolling 369 consecutive and initially normotensive
primigravidae. The ROT was applied within 28-32 weeks of pregnancy. PIH was
defined as diastolic blood pressure (DBP) 90 mm Hg or systolic blood pressure
(SBP) 140 mm Hg, or a rise in DBP 15 mm Hg or a rise in SBP 30 mm Hg. The ROT
prognostic properties were calculated, and a receiver operating characteristic (ROC)
curve was constructed.
RESULTS:
For the 20 mm Hg cutoff point, sensitivity was 20% and specificity was 93%.
Positive and negative predictive values were, respectively, 23% and 92%, for a PIH
cumulative incidence of 9.5%. With other cutoff points, the ROC curve showed a
poor discriminatory value of the test.
CONCLUSION:
The ROT was not useful for predicting PIH in a primary prenatal care setting.
Abstract
The utility of the roll-over test (ROT) as a prognostic tool for predicting
pregnancy-induced hypertension (PIH) was examined in primiparas in Quito,
Ecuador. In Study I, 14 of 16 subjects with a +ROT developed PIH (positive
predictive value (PPV) = 88%); only 2 of 27 subjects with a -ROT developed PIH
(negative predictive value (NPV) = 92.5%). In Study II (n = 66), the PPV and NPV
were 71.4% and 78.6%, respectively. Data from these and previous studies indicate
that although the ROT is not a perfect predictor, its advantages recommend usage in
populations with high PIH-associated maternal and perinatal mortality.
Kegunaan klinis dari uji bergulir dalam memprediksi kehamilan-induced
hipertensi pada populasi berisiko tinggi Andes.
Abstrak
Kegunaan tes roll-over (ROT) sebagai alat prognostik untuk memprediksi kehamilan-
induced hypertension (PIH) diperiksa di primipara di Quito, Ekuador. Dalam Studi I,
14 dari 16 subyek dengan ROT + dikembangkan PIH (nilai prediksi positif (PPV) =
88%), hanya 2 dari 27 subyek dengan ROT-dikembangkan PIH (nilai prediksi negatif
(NPV) = 92,5%). Dalam Studi II (n = 66), yang PPV dan NPV adalah 71,4% dan
78,6% masing-masing. Data dari studi ini dan sebelumnya menunjukkan bahwa
meskipun ROT bukanlah prediktor yang sempurna, keuntungan merekomendasikan
penggunaan pada populasi dengan tinggi PIH terkait kematian ibu dan perinatal.
http://onlinelibrary.wiley.com/doi/10.3109/00016348409157118/abstract
The influence of the patient's posture on the measurement of arterial blood
pressure has been studied during pregnancy. The blood pressure (BP) measured on
the right arm in the left lateral recumbent position is significantly lower than in the
supine, sitting, or erect positions. This difference is assumed to be due to hydrostatic
factors. The diastolic BP should be read off at Korotkoff IV because the hyperkinetic
circulation during pregnancy causes a pronounced variation in BP values when
measurements are performed at Korotkoff sound V. The roll-over test seems
inappropriate as a screening test to predict pre-eclampsia, because of the numerous
false-positive tests. The importance of measuring the BP under standardized
conditions during pregnancy in order to detect minimal changes in BP as indicative
of pathophysiology in pre-eclampsia is emphasized.
Pengaruh postur pasien pada pengukuran tekanan darah arteritelah
dipelajari selama kehamilan. Tekanan darah (BP) diukur di lengan kanan dalam
posisi telentang kiri lateral adalah lebih rendahdaripada di terlentang, duduk, atau
posisi tegak. Perbedaan inidianggap karena faktor hidrostatik. Tekanan darah
diastolik harus dibaca turun di Korotkoff IV karena sirkulasi hiperkinetik selama
kehamilan menyebabkan variasi diucapkan nilai BP saatpengukuran dilakukan
pada suara Korotkoff V. tes roll-overtampaknya tidak tepat sebagai tes
skrining untuk memprediksi pre-eklampsia, karena dari positif palsu berbagai
tes. Pentingnyamengukur BP dalam kondisi standar selama kehamilan untuk
mendeteksi perubahan minimal di BP sebagai indikasipatofisiologi dalam pra-
eklampsia ditekankan.