Which symptoms may indicate a suspected ectopic pregnancy in an adolescent?

In the context of a suspected ectopic pregnancy, hypotension and abdominal pain are critical symptoms to consider. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in a fallopian tube, leading to potential complications such as internal bleeding if the ectopic tissue ruptures.

Hypotension can indicate significant internal bleeding, which is a serious and life-threatening situation. This symptom, combined with abdominal pain—typically unilateral or localized in the lower abdomen—raises a high index of suspicion for an ectopic pregnancy. The abdominal pain may also vary from mild to severe and can sometimes be accompanied by shoulder pain due to referred pain from irritation of the diaphragm when there is bleeding.

Other options presented do not correlate with the classic presentation of ectopic pregnancy. For instance, a rash and fever are more indicative of an infection or other systemic illness rather than a specific sign of ectopic pregnancy. Similarly, urinary retention and fever could suggest a urinary tract infection, not an ectopic pregnancy. Lastly, while cervical abnormalities can occur in various gynecological conditions, they do not directly suggest an ectopic pregnancy, which primarily manifests through symptoms like abdominal pain and signs related to possible hemorrhage. Thus, hypotension and abdominal pain serve as more