Jørgen Løvset

Jørgen Løvset (1896-1981) was a Norwegian professor of obstetrics and gynecology.

Eponymously remembered for his 1937 description of Løvset’s Manoeuvre in the management of breech delivery.


Biography
  • Born on January 4, 1896 in Byneset, Norway
  • 1924 – Graduated medicine, University of Oslo
  • 1947 – Professor of obstetrics and gynaecology, University of Bergen
  • Died on August 15, 1981 in Bergen, Norway

Medical Eponyms
Løvset’s Manoeuvre (1937)

One of the potential dangers associated with vaginal breech delivery is extension of the arms as the trunk delivers. Løvset’s Manoeuvre involves rotation of the trunk of the foetus during a breech birth to facilitate delivery of the extended foetal arms and the shoulders.

In 1933, Løvset devised a simple and logical technique for dealing with this complication. He published the stages for breech delivery in 1937. Løvset advised this manoeuvre should be used for the delivery of the shoulders in all cases, but emphasised its particular value in those with extended arms.

During the last 4 years a trial has been made with a new method of shoulder-arm delivery in breech presentation, at the Women’s Hospital in Bergen. The theoretical basis for this procedure is that the posterior shoulder is always the lower one, owing to the pelvic inclination and the direction of the birth axis in the pelvic outlet.

When the body of the foetus is delivered so far that one may see or feel the inferior angle of the anterior scapula, the posterior shoulder is resting under the promontory of the sacrum. The position of the anterior shoulder at that time is behind or over the pubis.(fig 1)

If the body of the foetus is turned 180° with its back to the front, the shoulder will appear under the pubis if the body descends sufficiently during the last 90° to 130° of the manoeuvre. To make this possible the posterior shoulder must be below the promontory when the rotation begins, whether spontaneously or by traction.

Løvset 1937
Løvset’s Manoeuvre 1937 1-2-3 breech
Fig 1: After Farobeuf
Fig 2. Back to the left. Rotation starts in the direction of the arrow.
Fig 3. back nearly anterior. The body of the foetus now to be lowered and rotation continued in the direction of the arrow
Løvset’s Manoeuvre 1937 4-5-6 breech
Fig 4. The original posterior shoulder has appeared under the pubic arch.
Fig 5. The original posterior arm has descended and is brought out.
Fig 6. Rotating 180 degrees in the opposite direction to bring the original anterior shoulder forward again and under the pubic arch.
Løvset J. Shoulder delivery by breech presentation. 1937

The principle of the Woods Screw Manoeuvre (1943) for the management of shoulder dystocia relies on a similar rationale and understanding of foeto-pelvic anatomical relationships. In 1948, Løvset proposed a similar technique in the management of shoulder dystocia.


Medical Contributions

Løvset’s Umbilical Clip (1932)

Løvset constructed an umbilical clamp with locking forceps, for clamping the umbilical cord, post-delivery of the fetus. This instrument, complete with seaweed was used for all births in Norway for over 50 years.

This device has now been replaced by a rubber band or clip but follows the same principle.

Løvset’s Cervical Dilators (1933)

Løvset designed two- and four-blade steel dilator instruments used to gradually enlarge the cervix before performing a termination of pregnancy, to prevent damage during the procedure. These instruments were also used for the medical induction of labour until the 1980s. The use of such an instrument was common a practice for almost 40 years until it was replaced by the use of prostaglandin medications.


Controversies

Pioneering Work in Artificial Insemination of Infertility (1939)

In 1939, Løvset initiated the insemination of donor sperm into women who were married to infertile men. Løvset presented this to an international journal in 1951 and a Norwegian publication in 1952.

Anksel Sandemose, the author of Arstidene (the seasons) criticised such anonymous insemination in his magazine.

Løvset then defended his method in 1953.

Løvset’s ‘vaginal operative delivery’ book, published in 1968

Løvset’s book, vaginal operative delivery, was published to summarise his 35 years of experience in obstetrics and to teach younger colleagues necessary techniques. The book went to great lengths on recommendations for vaginal delivery, reserving caesarean section for only the rarest of circumstances, as in the case of placenta previa. It was published by Løvset in the concern that the art of vaginal delivery was weakening, largely due to performing caesarean sections instead.

Løvset received backlash from the Journal of Obstetrics and Gynaecology of the British Commonwealth.

Many of the manipulations are obsolete and highly dangerous. In the hands of the inexperienced, this book could prove positively legal.

Børdahl E, Hem E. 2001

Caesarean-sections as a delivery method of a breech lie (1976)

In 1976, Løvset was invited as a guest of honour to the annual meeting of the Norwegian Gynecological association. The programme included a lecture on caesarean sections as an alternative method of delivering a fetus in the breech position. Løvset declined to participate as he could not bear to listen to the idea that breech position should be an indication for a caesarean section.


Major Publications

References

Biography

Eponymous terms


Cite this article as: Jessica Hiller and Mike Cadogan, "Jørgen Løvset," In: LITFL - Life in the FastLane, Accessed on September 25, 2022, https://litfl.com/jorgen-lovset/.

eponym

the person behind the name

Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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