Following a rollover test performed in 306 nulliparous women in the 28th gestational week, Doppler flow velocity studies were conducted in all 34 women with positive rollover findings and in 67 women selected at random from those with negative findings. The mean systolic diastolic ratios in both the uterine and the umbilical arteries were significantly higher in women with positive rollover findings than in the control group. A review of the patients' medical records after delivery, indicated that this combined two-stage screening approach--a rollover test followed by a Doppler flow study--improved the predictive value and the sensitivity of the screening procedure from 35% and 39% respectively for the rollover test alone, to 56% and 50% with no decline in specificity. The sensitivity of the Doppler flow test as a single one among the 101 flow-studied women was higher--61%. However, broader studies are needed in order to establish its superiority as a single test for early prediction of pregnancy-induced hypertension.
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