Which patient is at an increased risk for ectopic pregnancy?

The patient most at risk for ectopic pregnancy in this scenario is the one who is a primigravida with endometriosis. Endometriosis is a condition where tissue similar to the lining inside the uterus grows outside it, which can lead to scarring and adhesions in the pelvic region. These changes can affect the normal function of the fallopian tubes, which are crucial for the transport of the fertilized egg to the uterus. If the fallopian tubes are blocked or damaged due to endometriosis, there is an increased likelihood that an embryo may implant outside the uterus, leading to an ectopic pregnancy.

Also, when considering the factors involved, a history of one or more conditions affecting the reproductive organs (like endometriosis) significantly raises the risk of complications such as ectopic pregnancy compared to mere age or past reproductive history alone. In this case, while increased age, multiple abortions, and other past reproductive conditions can play a role in reproductive risk, the specific implications of endometriosis make the second patient's situation particularly concerning for ectopic pregnancy.