The women's health diagnostic gap

Pregnancy remains a significant health risk to women in both developed and underdeveloped countries. Worldwide, 10 to 20 million women have pregnancy complications including ectopic pregnancy, preterm birth, gestational diabetes mellitus, and hypertensive states, including preeclampsia. Despite advancements in women's health research, there is a large gap in the diagnostic tools available to screen, diagnose, and monitor these conditions. Herein, we examine existing diagnostic tools, such as the human chorionic gonadotropin discriminatory zone, cervicovaginal fetal fibronectin, sFlt-1:PlGF ratio, and glucose tolerance testing. We suggest specific objectives to improve diagnostic testing during pregnancy, including (1) developing high-quality biospecimen banks; (2) educating professionals on performance characteristics of screening tests for low prevalence diseases; (3) funding studies that address diseases unique to pregnancy; and (4) establishing trimester-specific reference intervals. Meeting these objectives could begin to narrow the diagnostic gap in women's health. (Endocrinology 159:776-778, 2018).