Obsgynaecritcare

You get called down to labour ward to place an urgent epidural in a labouring nulliparous woman. When you get there the team inform you that "she is going crazy with the pain", they can't get her to hold still, they are having trouble monitoring the fetus and they are really worried she might be having an abruption. They plead "can you please do an epidural so we can get control of the situation?". The partner then tells you that she wasn't planning on having an epidural because when she was younger she was told "she had mild spina bifida" He doesn't know any other details but as long as he has known her - over 10 years - she has never had it looked into and he doesn't think she has ever had surgery. You glance at her back and notice a small dimple and a tuft of hair in the lower lumbar region and she looks like she might have a slight scoliosis, oh dear..... This week I have managed to corner one of the rising stars in our department Gareth Ansell an anaesthetic provisional fellow in his final year of tra