20 y/o Female, G2P1, 151kg, 5'9", HTN 151/90, Vitals WNL, Labs WNL, scheduled C-section for active HSV. Not actively contracting yet (39 weeks,5 days). Only meds are Prenatal vitamins. NKDA.
MPIV, Large tongue, TMD 2FB, predominant overbite. FHR: 130's

Prep/drape...Difficult spinal placed with Pencan 24 g at L3-4 interspace (2 attempts after having attempted at L4-5 space first). CSF swirl x 3, - heme, - paresthesia. Lay her supine with LUD. Legs are warm. 5 minutes pass legs not heavy,still warm, place her in T-burg. 10 minutes pass and sensory check difficult to determine (cold on neck feels warm to her as does the cold on thighs and abdomen....not able to tell a difference). FHR: 130's. Tells me her chest feels heavy. Take her out of T-burg. (Wanted to do a sharp/dull sensory exam but was waved off by MDA ).

Impatient surgeons prep and drape patient. Tell them she is NOT ready yet . Allis test-->OUCH ...big negative. :no: FAILED SPINAL. :aargh4: Whats the plan now?




P/S...It all worked out well