Munro A, et al. - Researchers performed a population-based cohort analysis using perinatal data from 1 January 2013 through 31 December 2014, to test their hypothesis that an epidural top-up in the second stage of labour attenuates operative deliveries by resolving inadequate analgesia. They determined the top-up incidence using an anesthesia database. They used descriptive statistics to compare for method of delivery and neonatal characteristics between women with or without a top-up for second-stage duration. A vaginal (spontaneous or assisted) delivery was documented for most women who received a top-up. They observed more predictors of difficult labour and higher rates of assisted vaginal delivery and Cesarean delivery among women requiring a top-up vs women without a top-up.