Red flags The following findings are of particular concern: Hemodynamic instability (hypotension, tachycardia, or both) Orthostatic changes in pulse or blood pressure Syncope or near-syncope Peritoneal signs (rebound, rigidity, guarding) Fever, chills, and mucopurulent vaginal discharge Interpretation of findings Clinical findings help suggest a cause but are rarely diagnostic (see table Some Causes of Vaginal Bleeding).