Which symptom can occur with ectopic pregnancy due to diaphragmatic irritation?

Which symptom can occur with ectopic pregnancy due to diaphragmatic irritation?

• A. Shoulder pain
• B. Headache
• C. Nausea only
• D. Visual disturbances

Answer: (A)

When the diaphragmatic lining or pleura is irritated by intra-abdominal blood from a ruptured ectopic pregnancy, the pain is referred to the shoulder. The diaphragm and its central part are innervated by the phrenic nerve (C3–5), so irritation transfers pain to the C4 dermatome, commonly felt as shoulder pain. This makes shoulder pain a classic sign of diaphragmatic irritation from hemoperitoneum in ectopic pregnancy. Headache or visual disturbances aren’t produced by diaphragmatic irritation, and nausea by itself is a common early-p pregnancy symptom not specifically tied to diaphragmatic irritation. The presence of shoulder pain in this scenario points toward diaphragmatic irritation from bleeding, raising concern for a rupture or significant intra-abdominal bleed in ectopic pregnancy.

When the diaphragmatic lining or pleura is irritated by intra-abdominal blood from a ruptured ectopic pregnancy, the pain is referred to the shoulder. The diaphragm and its central part are innervated by the phrenic nerve (C3–5), so irritation transfers pain to the C4 dermatome, commonly felt as shoulder pain. This makes shoulder pain a classic sign of diaphragmatic irritation from hemoperitoneum in ectopic pregnancy.

Headache or visual disturbances aren’t produced by diaphragmatic irritation, and nausea by itself is a common early-p pregnancy symptom not specifically tied to diaphragmatic irritation. The presence of shoulder pain in this scenario points toward diaphragmatic irritation from bleeding, raising concern for a rupture or significant intra-abdominal bleed in ectopic pregnancy.