Which symptom indicates marginal abruption?

Marginal abruption refers to a partial separation of the placenta from the uterine wall. One of the classic signs of this condition is bright red bleeding, which occurs as the blood from the separated area accumulates between the placenta and the uterine wall. This bleeding often indicates that there is significant placental distress, which can lead to severe abdominal pain.

In cases of marginal abruption, the intense abdominal pain accompanies the bright red bleeding, which is a key indicator of this condition. Recognizing this symptom is critical, as it often requires immediate medical attention to ensure the safety of both the mother and the fetus.

The other choices do not align with the classic presentation of marginal abruption. Consistent abdominal pain without visible bleeding may suggest other complications but not specifically marginal abruption. Pale vaginal discharge with low hCG levels could indicate a miscarriage or ectopic pregnancy but doesn't relate to abruption. Severe headaches and nausea without cramping could point to other issues such as preeclampsia or other conditions, but not directly to marginal abruption. Thus, the presence of bright red bleeding combined with intense abdominal pain is the hallmark symptom indicating marginal abruption.