Effective prevention of gestational hypertension in nulliparous women at high risk as identified by the rollover test.

The supine pressor (rollover) test was performed on a population of nulliparous patients between 28 and 32 weeks' gestation. Sixteen patients with abnormal test results were treated with increased rest in the left lateral recumbent position. Only one of this group developed gestational hypertension at term (6%), the rest remaining normotensive through delivery. A control group of 16 patients with abnormal test results were left untreated. Three patients of this group (19%) remained normotensive while 13 patients developed hypertensive complications (81%). Of the 13 patients who had hypertensive problems, nine developed preeclampsia and the remaining four had pregnancy-induced hypertension. A significant decrease was noted in the incidence of hypertensive complications in the patients treated with increased rest in the left lateral recumbent position when compared with the incidence in the control group and a composite of untreated patients in other studies. This treatment plan affords an economical approach for treatment of those at high risk for developing gestational hypertension and/or preeclampsia.