Prediction of pregnancy‐induced hypertensive disorders by angiotensin II sensitivity and supine pressor test

GA Dekker, JW Makovitz… - BJOG: An International …, 1990 - Wiley Online Library
GA Dekker, JW Makovitz, HCS Wallenburg
BJOG: An International Journal of Obstetrics & Gynaecology, 1990Wiley Online Library
An angiotensin II sensitivity test and a supine pressor test were done consecutively at 28
weeks gestation in 90 healthy, normotensive nulliparous women. None of the supine
pressor tests was positive, applying the predefined threshold of a rise of 20 mmHg in
diastolic blood pressure after rolling over; nine tests were positive using a corrected 9 mmHg
cut‐off level. Ten women had a positive angiotensin sensitivity test using a threshold of the
effective pressor dose of 8 ng/kg/min; 22 women were positive using an effective pressor …
Summary
An angiotensin II sensitivity test and a supine pressor test were done consecutively at 28 weeks gestation in 90 healthy, normotensive nulliparous women. None of the supine pressor tests was positive, applying the predefined threshold of a rise of 20 mmHg in diastolic blood pressure after rolling over; nine tests were positive using a corrected 9 mmHg cut‐off level. Ten women had a positive angiotensin sensitivity test using a threshold of the effective pressor dose of 8 ng/kg/min; 22 women were positive using an effective pressor dose of 10 ng/kg/min. Later in pregnancy 12 women (13%) developed pregnancyinduced hypertensive disease (PIH). The specificity of both tests of predicting the development of PIH was about 90%. The sensitivity of the angiotensin sensitivity test at the 10 ng/kg/min level was 92%. Because of its low sensitivity of 25% the supine pressor test appears to have no value for the prediction of PIH. There was a significant positive association between angiotensin IT refractoriness and birthweight.
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