Cervical motion tenderness
, peritoneal signs, and adnexal masses are most specific for ectopic pregnancy, but are not sensitive?
On per vaginum examination, uterus was anteverted, bulky and soft with marked tenderness in left fornix, palpable left adnexal mass with cervical motion tenderness
Pelvic exam revealed normal mucosa with thin white cervical discharge and cervical motion tenderness
. Exam of the extremities showed no joint effusions or induration, but arthralgia was noted in both of her elbows, knees, and wrists.
of cases % Symptoms Pain abdomen 45 90 Amenorrhea 43 86 Bleeding PV 30 60 Vomiting/nausea 11 22 Fever 03 6 Fainting attacks 01 2 Signs Pallor 24 48 Hypotension and shock 08 16 Abdominal tenderness 43 86 Guarding 07 14 Distension 12 24 Cervical motion tenderness
40 80 Fornicial tenderness 36 72 Mass in the fornix 16 32 Table 3: Ultrasonographic findings (n=50) Ultrasonographic Findings No.
(13) Acute PID should be suspected in all patients with acute pelvic pain found to have cervical motion tenderness
and bilateral adnexal tenderness.
Tenderness over lower abdomen was seen in 33(76.74%) patients and the classical sign of cervical motion tenderness
was seen in 19(44.19%) cases.
Bimanual examination revealed cervical motion tenderness
and right adnexal tenderness, uterus was anteverted and of normal size.
Uterine size could not be assessed properly, no pelvic masses were felt, pouch of Douglas was full and there was marked cervical motion tenderness
. Her urine pregnancy test was faintly positive.