Poster Session 3
.jpg "Madhurima K. Keerthy, MD, N/A photo")
Madhurima K. Keerthy, MD, N/A
Fellow Physician
University of New Mexico
Albuquerque, NM, United States
Vivek Katukuri, MD
MFM attending
University of New Mexico
Albuquerque, New Mexico, United States
Christina Yarrington, MD
University of New Mexico
Albuquerque, New Mexico, United States
Christopher Cox, MD
University of New Mexico
Albuquerque, New Mexico, United States
Conrad Chao, MD
MFM division head, Department of Obstetrics and Gynecology
University of New Mexico
Albuquerque, New Mexico, United States
Chloe Fournier-Hall, MD
University of New Mexico
Albuquerque, New Mexico, United States
Mingma Sherpa, MD
University of New Mexico
Albuquerque, New Mexico, United States
Pre-eclampsia occurs in 3-8% of pregnant patients globally and is more detrimental to rural communities with limited access to care. Early diagnosis and management improve maternal and neonatal outcomes. The screening modalities that are available include mean Blood pressures, uterine artery Dopplers and various angiogenic markers. However, these are not available to rural areas consistently. The aim of our study to evaluate the potential of the low-cost Roll-Over Test to predict hypertensive disease of pregnancies in rural populations.
Study Design:
This is a single center pilot prospective cohort study. 56 patients were recruited. Demographic data, Uterine artery Doppler and blood for sflt1/Plgf ratio was obtained between 19wk0d – 24w6d. Roll-over Test was conducted by obtaining blood pressures in left lateral and Supine positions, mean change in BP was collected. T-test (continuous) and Chi Square test(categorical) were used for demographic variables.
Receiver Operating Characteristic (ROC) curves generated for ROT change in SBP, DBP and HR for prediction of primary outcome. ROC curves generated for UA PI, First SBP (Initial Systolic BP in pregnancy) and First DBP (Initial Diastolic BP in pregnancy).
Sensitivity and specificity calculated for ROT, Ut PI, First SBP and First DBP.
Results: 14 (26.9%) had primary outcome. 5 (9%) had preeclampsia and 9 (17%) had gestational hypertension. Of the 5, one (1.9%) had HELLP syndrome. A 17-point change in systolic BP on ROT had an optimal sensitivity of 60% and specificity of 80% in diagnosing the primary outcome. A mean diastolic change of 9.6 points was identified to provide a sensitivity of 85% and a specificity of 55%. In this population, Uterine artery Dopplers and angiogenic markers did not perform well in predicting primary outcome.
Conclusion: The low-cost Roll-Over Test is a reasonable screening tool to predict hypertensive disease in pregnancy in rural settings.
