Malik T, et al. - As anesthesiologists typically use the iliac crest as a landmark to choose the L3-4 or L2-3 interspace for labor epidural catheter placement on the basis of experience or training with no evidence-based recommendation to guide the exact placement, researchers investigated if lower placement of the catheter would lead to a higher incidence of S2 dermatomal block and improved analgesia in late labor and at delivery. They randomized 100 parturients requesting epidural analgesia to receive ultrasound-guided L5–S1 epidural catheter placement (experimental group) or non-ultrasound-guided higher lumbar interspace placement (control group). Outcomes revealed no improved sacral sensory block coverage with the placement of an epidural catheter at the L5–S1 interspace using ultrasound when compared with an epidural catheter placed at a higher lumbar interspace, without using ultrasound guidance.