Nutritional factors and rest reduce pregnancy-induced hypertension and pre-eclampsia in positive roll-over test primigravidas. Effective prevention of gestational hypertension in nulliparous women at high risk as identified by the rollover test.
The possibility of reducing pregnancy-induced hypertension and preeclampsia in primigravidas with low doses of nutritional factors and relative rest in the left lateral position was investigated in a randomized controlled, double-blind trial.
                Seventy-four normotensive women at 28-29 weeks' gestation, judged to be at risk of PIH or pre-eclampsia because they presented with a mean blood pressure of 80 mmHg or higher and a positive roll-over test, were studied. The treatment protocol was received by 37 women and the other 37 women received standard antenatal control until delivery.
                Twenty-nine (78.3%) women in the control group developed PIH and/or pre-eclampsia, as opposed to only 4 (10.8%) cases in the treatment group (P < 0.001). There were no adverse effects of treatment in mothers or in infants.
                This protocol reduces PIH and pre-eclampsia in primigravidas judged to be at risk of hypertension. Further studies are required to evaluate prostacyclin and prostaglandin E2 changes. 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.
Daily rest, with or without nutrient supplementation, may reduce the risk of pre-eclampsia for women with normal blood pressure, although the reported effect may reflect bias and/or random error rather than a true effect. There is no information about outcomes such as perinatal mortality and morbidity, maternal morbidity, women's views, adverse effects, and costs. Current evidence is insufficient to support recommending rest or reduced activity to women for preventing pre-eclampsia and its complications. Whether women rest during pregnancy should therefore be a matter of personal choice.