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To the Editor:—
The article in The Journal August 19 on this subject leaves many questions of doubt as to whether the emboli of air were due to air sucked in at the time that the knee-chest posture was assumed.The explanation of the modus operandi of the air getting into the vessels is far from convincing when the condition of the uterine muscle and its interior and the question of physics are considered.The vagina is a membranous pouch which may be expanded with air with the subject in the knee-chest posture by suction exerted when the abdominal viscera drop toward the chest. The uterus is a heavy, thick walled muscular organ the tendency of which is to contract rather than dilate, and it is questionable whether the weight of the viscera would be sufficient to cause dilatation enough to fill the uterus with air, as it has a
Hummel EP. EMBOLISM FOLLOWING KNEE-CHEST POSITION POST PARTUM. JAMA. 1939;113(13):1243. doi:10.1001/jama.1939.02800380061025
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