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IMPLICATIONS: The current ASA Physical Status Classification does not consistently address the physiological changes of pregnancy. The use of a modifier, G (for gravid), reduces inconsistency in assigning the ASA Physical Status Classification.

The American Society of Anesthesiologists Physical Status Classification (ASA PSC) was developed in 1941 to provide a simple and concise summary of a patient’s preoperative health status and to allow the stratification of data for statistical analysis (1). The definitions are based on severity of disease and may result in inconsistent application (2–5). The pregnant patient presents physiologic disturbances that may increase her anesthetic risk and require special attention in her anesthetic management; these factors are not included in a disease state stratification. A pilot study we conducted demonstrated broad discrepancies in the ASA PSC assigned to an otherwise …