ROLL-OVER TEST

ROLL-OVER TEST

INTRODUCTION

It is simple clinical test to detect at risk mothers particularly primigravida who are likely to develop PIH later on in the same pregnancy. However due to high false positive rate it is not much used clinically.

METHODOLOGY

Usually it is done between 28 – 32 weeks of pregnancy but in cases of multiple pregnancy and other high risk patients it is advisable to do test earlier that is after 24 weeks.

The mother is asked to lie down in left lateral position and BP is taken in right upper limb after 15 minutes, then the patient is turned to supine position and BP is again taken after 5 minutes.

INTERPRETATION

Increases of 20mmHg in diastolic pressure in supine position indicates positive “Roll over test” if the test is positive 60 – 70% patients develop pre-eclampsia later on. Negative test is more reliable that is more than 95% patients do not develop pre-eclampsia when it is negative. The exact mechanism by which supine position causes rise in BP is not clear but it may be due to intrinsic vascular hypersensitivity in such patients.