Ectopic Pregnancy: The Daily PANCE Blueprint

The answer is B. Lower Abdominal Pain

Lower abdominal pain is the most common presenting symptom in ectopic pregnancy. The pain is typically unilateral, localized to the side of the ectopic implantation, and may be accompanied by vaginal bleeding and signs of hemodynamic instability if rupture occurs. In ectopic pregnancy, the fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tube, leading to complications such as rupture, hemorrhage, and hemodynamic collapse. Diagnosis is confirmed by a combination of clinical presentation, a positive pregnancy test, and pelvic ultrasound showing an empty uterus or an adnexal mass. Early recognition and management are critical, and treatment typically involves methotrexate for stable cases or surgical intervention for unstable or ruptured ectopics.

Incorrect answer explanations:

• A. Positive Murphy’s Sign – Murphy’s sign is associated with acute cholecystitis and involves pain on palpation of the right upper quadrant during inspiration. It is unrelated to ectopic pregnancy.
• C. Grey Vaginal Discharge – Grey vaginal discharge is characteristic of bacterial vaginosis, not ectopic pregnancy. Vaginal bleeding, not discharge, is more commonly associated with ectopic pregnancy.
• D. Chocolate Cyst in Ovary – Chocolate cysts are a feature of endometriosis, representing ovarian endometriomas filled with old blood. They are not seen in ectopic pregnancy.
• E. Auspitz Sign – Auspitz sign refers to pinpoint bleeding observed after removing psoriatic scales. It is not relevant to the presentation or diagnosis of ectopic pregnancy.