BMJ Case Reports 2018; doi:10.1136/bcr-2017-222950
  • Reminder of important clinical lesson

21st century obstetrics: a 50-year-old nullip—walk in the park?

  1. Vinita Singh1
  1. 1Obstetrics and Gynaecology, The Royal Free Hospital, London, UK
  2. 2Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK
  1. Correspondence to Dr Deepa Balachandran Nair, manodeepam{at}
  • Accepted 26 January 2018
  • Published 8 February 2018


We discuss the case of a 50-year-old nulliparous woman who conceived after in vitro fertilisation. She had multiple medical comorbidities and presented an obstetric and medical challenge. She was carefully managed through pregnancy and had a successful outcome. In this report, we explore the medical complexity, as well as ethical and logistic issues involved.


  • Contributors DBN, VS and DPG designed and drafted the initial article while DBN and DPG analysed and interpreted the case and reviewed the literature. Finally, all three authors revised the manuscript critically. All authors listed on the manuscript have seen and approved the submitted letter and take full responsibility for the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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