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A 23-year-old woman presents with significant pelvic pain. Why?

NursingSKL clinical tip

By NursingSKL
July 10, 2023
iStock/ajr_images; NursingSKL

Pelvic pain can be a potentially serious problem. Every nurse needs to think about eliciting two critical pieces of information when assessing a patient with this complaint.

  1. First, is the patient hemodynamically stable? Are symptoms such as light-headedness and dizziness present? Is the patient hypotensive or tachycardic? If there is excessive blood loss due to an ectopic pregnancy, the patient can quickly become unstable. Ectopic pregnancy occurs when fetal implantation does not occur in the uterine wall, but instead in another location — most frequently the fallopian tube, ovary, cervix or abdomen.
  2. Second, when was the last menstrual period? Testing for beta-hCG levels will confirm the presence of a pregnancy. Other non-pregnancy related causes of pelvic pain can include ovarian torsion, ruptured ovarian cysts, and tubo-ovarian abscess.

The patient was noted to have a blood pressure of 100/60 mmHg and her pulse was 100 bpm. This patient’s blood work confirmed pregnancy; her beta-hCG levels estimated a six-week pregnancy. The patient was treated with surgery.

Clinical tip: In any woman with pelvic pain, consider the possibility of ectopic pregnancy (especially if she is hemodynamically unstable).


In this video, you will learn the three questions that every nurse should ask their patient to identify the causes of pelvic pain that are associated with an emergency.

This clinical tip was provided by NursingSKL, a collaborative initiative between leading doctors and nurses to improve nurses’ clinical skills. Go to to find out more, meet the faculty, and try our free Practicum on Diabetes Care.
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