A historical analysis of Tsovyanov's and Bracht's manoeuvres for breech birth


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Abstract

In Russia vaginal breech deliveries are performed according to theTsovyanov method (1928). Practically the same method is used in many European and South American countries, but is named after Bracht (1935) . We performed a historical analysis of the method and manoeuvres of Tsovyanov and Bracht. The source texts of both methods were examined to see if there were any similarities and/or differences and to see who might have been f irst if they were completely identical. The main purpose of Tsvyanov ‘s manoeuvre is to try to preserve the physiological position of the foetus (legs extended and pressed against the trunk like a splint, arms crossed in front of the chest), and ensure that the foetus is guided in the direction of the axis of the birth canal. After crowning of the breech, the gynaecologist grasps the buttocks of the foetus with both hands, so that the thumbs are placed on the thighs, while the other four fingers of both hands lie on the surface of the sacrum of the foetus. Bracht 's philosophy was as follows: ‘Gravity drastically disturbs the birth in supine position in humans from the moment that about half of the child's trunk is born. The sensible arrangement of the individual foetal parts is disturbed and leads to complications. This disintegration is prevented by the manual manoeuvre introduced by me (= Bracht)’. This is a case of a "classic multiple discovery". Conclusion: The theory of both methods is the same. But Tsovyanov, unlike Bracht, did not use expression.

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About the authors

Nadejda N. Van Grinsven-Dmitrieva

Isala Kliniek

Email: n.n.van.grinsven@isala.nl; nadezjda@hotmail.com
gynaecologist; Sworn translator/interpreter Russian-Dutch Scharten-Antinkstraat 4, 8023 CD, Zwolle, Netherlands

A. T.M Verhoeven

Isala Kliniek

Email: atmverhoeveni@gmail.com
gynaecologist n.p., formerly Rijnstate Ziekenhuis Arnhem, Working Group History of the Dutch Society of Obstetrics and Gynaecology Van Heemstralaan 9, 6814KA Arnhem, Netherlands

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