Which of the following symptoms indicates possible internal bleeding in a case of ectopic pregnancy?

Hypotension, or low blood pressure, is a critical symptom that can indicate possible internal bleeding in the context of an ectopic pregnancy. When an ectopic pregnancy ruptures, it can lead to significant blood loss within the abdominal cavity. This loss of blood volume can cause the body’s blood pressure to drop, resulting in hypotension. Monitoring blood pressure in these situations helps to assess hemodynamic stability; a significant drop in blood pressure may signify that the patient is experiencing internal bleeding.

The other symptoms listed may also occur in cases of ectopic pregnancy but are not as direct indicators of internal bleeding. For instance, abdominal distension can result from various causes, including accumulation of fluid or gas and doesn’t necessarily indicate internal bleeding. Vomiting could be a sign of several conditions, including pain or discomfort, but it is nonspecific in relation to internal bleeding. Increased heart rate, while it can be associated with stress or pain and even compensatory mechanisms due to blood loss, is less definitive than hypotension for diagnosing internal bleeding specifically. Thus, hypotension is a more critical indicator in this scenario.