Suboptimal Labour Epidural Progressing to Emergency Caesarean
Reading Time
2:00
Clinical Stem
2025.2
You are the consultant anaesthetist covering labour ward.
A 24-year-old woman in her first pregnancy (G1P0) had an epidural inserted by your registrar four hours ago. Your registrar is now attending to another patient, and the midwife phones you to ask if you can attend and assess the effectiveness of epidural pain relief as the patient is still complaining of pain.
The midwife tells you the epidural was difficult to insert, requiring multiple attempts from your registrar.
Sections covered in this viva
Section 1 – Assessment and optimisation of labour analgesia in a parturient with a suboptimal epidural blockSection 2 – Anaesthetic decision-making and induction planning for emergency caesarean section in a hypertensive parturient with failed neuraxial blockSection 3 – Recognition and management of peripartum dyspnoea and cardiomyopathy in the recovery unit