Just thought I'd share this with the boards, as of all the AOs I feel Shub-Niggurath's flip-side builds to something that then never manifests. I came up with this as a way of giving the game a more definitive conclusion, and it worked really well for me. In fact, it gave me one of my very best games. I'd love to hear how it plays out for someone else, should they try it.
So, when Shub-Niggurath awakens, play as normal until (if and when) she achieves her standard victory conditions.
At this point, instead of losing the game, introduce a new phase to the round - The Hunt phase. And for a little flavour:
The unholy horror of Shub-Niggurath has woken and gathered her evil around her. Now, the mother of monsters calls out to all the terrors of the world. Everywhere is unleashed a tide of death and madness, seeking to destroy all those who would defy the dark mistress. Now, the Hunt begins....
The Hunt phase takes place after the Encounter phase and before the Mythos phase.
During the Hunt phase, all monsters on the map begin actively hunting the investigators (with exception to Shub-Niggurath and any location-specific monsters, such as Serpent Men, Giant Penguins, etc).
Monsters move one space closer to the nearest investigator, or, if there are three or more monsters grouped together, they each move one space along different paths to create a slowly spreading monster-net.
If a monster moves into a space containing an investigator, it immediately attacks that investigator (or investigators) and remains on the space if not defeated.
If a monster moves into a space adjacent to an investigator, it may ambush that investigator (but only one, if there are others sharing the space). If the monster is not defeated, it then retreats back to its original adjacent position.
At the end of every Hunt phase, each investigator that does not have a Hunted condition gains a Hunted condition.
When Doom would advance, spawn 2 monsters in the Heart of Africa.
The game continues until Shub-Niggurath is slain or all investigators are defeated.