Findings that suggest a cause include Vaginal bleeding accompanying the pain: Spontaneous abortion or ectopic pregnancy An open cervical os or tissue passed through the cervix: Generally, an inevitable, incomplete, or complete abortion Presence of fever, chills, and a purulent vaginal discharge: Septic abortion (particularly in patients with a history of instrumentation of the uterus or illicitly attempted termination of pregnancy) Pelvic inflammatory disease is rare during pregnancy but may occur.