Though multiple myeloma is not commonly encountered in emergency practice, earlier identification of relatively subtle symptoms can allow early treatment. Missing this diagnosis will delay treatment and produce severe outcome to the patient. We should be on the alert for such important condition.

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Objectives: To review the pregnancy outcomes of non-booked, non-local pregnant women delivering in Kwong Wah Hospital via admission to the Accident and Emergency Department 1 year after the announcement by the Hospital Authority to stop antenatal booking for non-eligible persons; and to perform a literature review of local studies about non-eligible person deliveries over the last decade. Design: Case series.Setting: A public hospital in Hong Kong. Participants:All women who held the People's Republic of China passport or the two-way permit and those non-eligible persons whose spouses were Hong Kong Identity Card holders, who delivered in Kwong Wah Hospital from 1 April 2011 to 31 March 2012.Results: Overall, 219 women who were non-eligible persons delivered 221 live births during the study period. Compared with the annual statistics of Kwong Wah Hospital in 2011, non-local mothers were of higher parity; more likely to have hypertensive disease (including pre-eclamptic toxaemia), preterm deliveries (ie at <37 weeks), babies needing admission to the special care baby unit, and macrosomic babies (ie weighing >4.0 kg). The rates of induction of labour and caesarean section were lower in this group. There was no significant difference in the maternal and neonatal outcomes between women who had no booking and those who had a booking in another Hospital Authority or private hospital. There were Social obstetrics: non-local expectant mothers admitted through accident and emergency department in a public hospital in Hong Kong IntroductionThe influx of expectant mothers from Mainland China leading to overwhelming of the local obstetric and neonatal services has been a hot topic of discussion in the media in the past few years. In New knowledge added by this study • Non-eligible person (NEP) delivery in Hong Kong has been a social obstetric phenomenon specific to this region (Hong Kong SAR) because of political circumstances. Despite the reduction in the quantity, these nonbooked deliveries continue to run a high risk of adverse obstetric outcomes due to difficulties experienced by the expectant mothers in accessing a well-structured obstetric service. Implications for clinical practice or policy • Regardless of the number of patient load, the NEP women remain potentially at risk of obstetric complications.Health care professionals should be prepared for managing the near-miss conditions.