What finding should lead to a suspicion of ectopic pregnancy in a woman with abdominal pain?

A recent history of pelvic inflammatory disease (PID) is a significant factor that can raise suspicion for an ectopic pregnancy in a woman presenting with abdominal pain. PID can lead to scarring and damage to the fallopian tubes, which increases the risk of an ectopic pregnancy since the fertilized egg may implant in a tube rather than the uterus. The presence of abdominal pain in conjunction with a history of PID should prompt further investigation for ectopic pregnancy.

In contrast, menstruation occurring just three days prior is typically not associated with a higher risk of ectopic pregnancy, as it may indicate a recent normal menstrual cycle rather than a reproductive complication. Similarly, a spontaneous abortion that occurred six months ago does not directly link to a current pregnancy complication like an ectopic pregnancy. Finally, while a cesarean section scar may present its own set of concerns, it is not particularly linked to the risk of ectopic pregnancy in the way that prior pelvic inflammatory disease is. Thus, the connection between PID and ectopic pregnancy makes it the correct response in this scenario.