You are working on the obstetric unit and are called to see a 30-year-old primigravida with a BMI of 41. The patient is having regular contractions and the cervix is dilated to 4 cm. She is coping...

You are working on the obstetric unit and are called to see a 30-year-old primigravida with a BMI of 41. The patient is having regular contractions and the cervix is dilated to 4 cm. She is coping well on entonox currently, but asks you if, and when, you would advise siting an epidural. Which would be the most appropriate response? a. Advise that she has an epidural when she can no longer manage labour pain with entonox alone b. Assess her airway and, if found to be difficult, advise early epidural insertion c. Site iv access, explain the procedure and take consent, so that you are ready to place an epidural at short notice if required d. Advise early epidural and iv access regardless of current pain level and airway assessment e. Examine the patient’s spine and judge potential for difficulty before deciding on the course of action