What symptom might indicate placental abruption in a pregnant female?

The presence of dull shoulder ache and vaginal bleeding is indicative of placental abruption, a condition where the placenta separates from the uterine wall before delivery. This separation can lead to significant maternal and fetal complications, and vaginal bleeding is a key symptom as the detachment can cause blood to escape from the uterus. A dull shoulder ache can also occur due to referred pain, as irritation of the diaphragm from internal bleeding can result in shoulder discomfort.

In contrast, while severe abdominal cramps can be associated with various conditions in pregnancy, they are not specific to placental abruption. Persistent nausea and vomiting typically suggest different conditions such as hyperemesis gravidarum or can be common in early pregnancy. Abnormal fetal movement may also manifest in cases of placental complications, but it is not as directly associated with placental abruption as the combination of dull shoulder ache and vaginal bleeding. Thus, the signs of internal bleeding and associated discomfort in the shoulder serve as significant clinical indicators of placental abruption.