Case Presentation
A 24-year-old pregnant woman, primigravida, presented to the labor and delivery unit, at 39.4 weeks gestation, in active labor. Her pregnancy was complicated by gestational diabetes and obesity (body mass index, 40 kg/m2). She requested labor analgesia at 3 cm cervical dilation.
The epidural space was identified at the L4-L5 intervertebral space at 8 cm from the skin, and the epidural catheter was inserted 5 cm into the