In a retrospective study of 150 pregnant women with high or low serum HCG levels at the time they sought acute advice at the ward, two categories of women were found: a majority (n = 111) who had abdominal pain and/or vaginal bleeding, and a minor group (n = 39) who worried about their condition but were otherwise symptom free. The underlying reason for the difference in clinical outcome amongst ‘bleeding’ and ‘concern’ women with both high and low HCG serum values are discussed. It is concluded that women with abnormal HCG levels in early pregnancy deserved close attention in the 3rd trimester.