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described the management of a morbidly obeseparturient with umbilical cord prolapse (UCP) and a stablefetal heart rate (FHR), who was administered spinal anes-thesia in the knee-chest position for urgent Cesareandelivery. While the management was successful, we offercomments and address systematic aws that may reducethe likelihood for the need to use unorthodox management.While UCP is rare (incidence 0.15–0.2%), unfortu-nately, the need for operative delivery and anesthesiaintervention in the obese obstetric population is notuncommon and should be anticipated. The difculties ofneuraxial anesthesia in morbidly obese parturients are wellestablished.

We “can do it” does not mean we “should do it”: obesity, umbilical cord prolapse, and spinal anesthesia in the knee-chest position