Uyl N, et al. - In obese pregnant women who receive epidural analgesia during delivery, researchers determined the rate of epidural failure and difficulties during epidural placement by analyzing evidence from eight studies in the systematic review and four in the meta-analyses. These studies were identified from PubMed, Embase, Medline and Google scholar and involved obese pregnant women and non-obese pregnant women who had epidural failure and/or difficulties in epidural placement. The studies that used ultrasound during epidural placement were excluded. At least two-fold increase in the risk of epidural failure and difficult epidural placement during delivery was reported in relation to obesity in pregnant women in the examined studies. Findings also revealed that this risk increased with increasing body mass index.