Should a spinal be used for surgical anesthesia after a failed labor epidural?

Abstract

The obstetrical team (OB) calls the anesthesia resident to inform him that one of the laboring patients will have a cesarean delivery for failure to progress. The anesthesia resident calls his attending: "I am calling to discuss our 24-year-old G1P0 parturient in labor room 8 who will be having a cesarean delivery for failure to progress. The patient’s medical history is significant only for obesity. She denies any surgeries in the past. Her airway examination reveals a Mallampati 3, with good mouth opening, normal thyromental distance, full range of motion, and a short, thick neck. We placed her epidural this morning, and I have been asked to give additional medication (top-up) three times since then.