Which symptom might indicate a ruptured ectopic pregnancy in an adolescent?

A ruptured ectopic pregnancy is a serious medical condition that can occur when a fertilized egg implants outside the uterus, commonly in a fallopian tube. This situation can lead to internal bleeding, which subsequently causes symptoms indicative of hemodynamic instability, such as hypotension (low blood pressure).

Abdominal pain, particularly if it's sudden and intense, suggests that the ectopic pregnancy may have ruptured. In conjunction with hypotension, this combination is a critical sign of potentially life-threatening internal bleeding that requires immediate medical attention. Hypotension indicates that the body is not maintaining adequate blood flow to the organs, which can result from significant blood loss due to rupture.

While nausea, vaginal bleeding, and constipation may occur in a variety of conditions, they do not specifically point to the danger associated with a ruptured ectopic pregnancy. For instance, nausea is often present in many common conditions unrelated to pregnancy status, while vaginal bleeding can occur for reasons other than rupture. Constipation is not a relevant symptom for this particular diagnosis and does not indicate any acute or critical condition.

In summary, abdominal pain combined with hypotension presents a clear and urgent clinical scenario associated with a ruptured ectopic pregnancy in an adolescent, making it the most critical indicator for