Risk factors for ectopic pregnancy include Previous ectopic pregnancy (the most important) History of sexually transmitted infection or pelvic inflammatory disease Cigarette smoking Use of intrauterine device Age > 35 Previous abdominal surgery (especially tubal surgery) Use of fertility drugs or assisted reproductive techniques Multiple sex partners Douching Risk factors for spontaneous abortion include Age > 35 History of spontaneous abortion Cigarette smoking Drugs (eg, cocaine, alcohol, high doses of caffeine) Uterine abnormalities (eg, leiomyoma, adhesions) Risk factors for bowel obstruction include Previous abdominal surgery Hernia Physical examination Physical examination begins with a review of vital signs, particularly for fever and signs of hypovolemia (hypotension, tachycardia).