Which of the following is a sign associated with ectopic pregnancy?

A sign associated with ectopic pregnancy is spotting that occurs around 6 to 8 weeks after the last menstrual period. This timeframe aligns with when an ectopic pregnancy would typically present with symptoms, as implantation outside of the uterus often leads to bleeding or spotting. This bleeding may be lighter than a typical menstrual period and can signal a potential complication of the pregnancy where the developing embryo is unable to implant properly in the uterine lining, leading to abnormal symptoms.

The other options present common signs that can be misleading in the context of an ectopic pregnancy. Severe abdominal pain is indeed a significant sign, as it can indicate rupture or other complications, but it is not unique to ectopic pregnancies. Heavy bleeding can occur in different types of pregnancy complications, making it less specific. Elevated blood pressure is not a standard sign associated with ectopic pregnancy and could relate to other physiological changes or unrelated conditions. Spotting, particularly the timing of 6–8 weeks, provides a clearer association with the diagnosis of ectopic pregnancy, distinguishing it from other possible events in early pregnancy.