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Fruit size as a model for teaching first trimester uterine sizing in bimanual examination
1Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA. lmiller@u.washington.edu
Objective:
To examine a commonly used fruit-comparison model for teaching uterine sizing by bimanual examination, to compare the sizes of actual fruits with published first trimester uterine ultrasound measurements, and to estimate the degree of provider agreement with this model.
Methods:
Actual fruits (pears, juice oranges, navel oranges, and grapefruits) were measured. Published ultrasound measurements of first trimester pregnant uteri were compared with the fruit measurements. A questionnaire was developed and sent to a community-based sample of 300 women's healthcare providers selected from a local medical society roster of obstetrician-gynecologists and a local reproductive healthcare provider list.
Results:
One hundred twelve (37%) of 300 questionnaires were returned. Of these respondents, 55% were medical doctors, 41% nurse-practitioners, and 4% midwives. Overall, 75% of respondents agreed (responded either "Agree" or "Strongly agree") that a nonpregnant or 5-week pregnant uterus feels like a small, unripe pear. Sixty-one percent agreed that a 6-week pregnant uterus feels like a small (juice) orange. Eighty percent agreed that an 8-week pregnant uterus feels like a large (navel) orange. Eighty-one percent expressed agreement that a 12-week pregnant uterus feels like a grapefruit.
Conclusion:
The degree of provider agreement with the fruit-based teaching model indicates potential utility of the model.