Uyl N, et al. - Since the rates of obese pregnant women who receive epidural analgesia during delivery are increasing, therefore, researchers assessed epidural failure rate and problems during epidural placement in these women. In a systematic review and meta-analyses, they analyzed 8 and 4 articles, respectively, out of 221 articles that were identified from PubMed, Embase, Medline and Google scholar. A link between BMI and epidural failure was described in five out of six studies, and a link between BMI and difficult epidural placement or multiple attempts was reported in four out of five studies. At least two-fold increased risk of epidural failure and difficult epidural placement during delivery was observed in relation to the presence of obesity in pregnant women. A rise in this risk was evident with increasing BMI.