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A positive peritoneal sign in the context of an ectopic pregnancy indicates that there is irritation of the peritoneum, usually due to an internal hemorrhage associated with the rupture of the ectopic pregnancy. This sign manifests as abdominal tenderness or pain, particularly during palpation or percussion of the abdomen, reflecting a pathological condition that may require immediate medical intervention.

When an ectopic pregnancy ruptures, blood spills into the peritoneal cavity, leading to inflammation and irritation, which is what the peritoneal sign reveals. This clinical indicator suggests a critical state and often prompts further evaluation and management to address the potential life-threatening consequences of a ruptured ectopic pregnancy, such as internal bleeding.

In contrast, normal fetal development or a healthy uterine environment would not present with a positive peritoneal sign, as these conditions do not typically involve peritoneal irritation. Similarly, low risk of complications would indicate a stable situation, which is inconsistent with the implications of a positive peritoneal sign. Thus, the correct answer underscores the significance of a positive peritoneal sign as an indication of a potentially serious complication, such as rupture in the setting of an ectopic pregnancy.