The development of a program mainly centered on the promotion of a cultural change in the approach to medical errors can effectively diminish medication errors in neonates and children.

Our data suggest that prophylactic theophylline, given early after birth, has beneficial effects on reducing the renal dysfunction in asphyxiated full-term infants. (ABSTRACT TRUNCATED)

This study was a small-scale, "quasirandomized," controlled trial carried out to determine the effectiveness and safety of cervical cerclage performed using the McDonald technique in patients with symptomatic placenta previa. Outcomes were compared in 18 women undergoing cerclage and 19 control women. Criteria for admission to the study included painless vaginal bleeding, a gestational age of 20 to 34 weeks, and sonographic confirmation of the diagnosis. Gross congenital anomalies, other complications, type 1 placenta previa more than 2 cm from the internal os, and a cervical length less than 3 cm, noted on speculum examination 24 hours after bleeding stopped, were criteria for exclusion.Patients were placed on bedrest, sedated if bleeding was present, and given steroids weekly from 28 to 34 weeks gestation. Blood was transfused as needed. The McDonald stitch was placed under antibiotic prophylaxis and tocolysis that began 1 hour before cerclage and continued for 48 hours postoperatively. If placenta previa was characterized as "minor," patients were discharged 3 days after cerclage. Pregnancies were terminated at 37 weeks gestation.All but one of the end points recorded differed significantly between the cerclage and control groups, the exception being the amount of blood transfused. Cerclage patients had fewer major hemorrhagic episodes and fewer episodes associated with blood clots or signs of hypovolemia. In none of 10 patients with minor placenta previa who had cerclage and subsequent normal-term vaginal delivery was the placenta felt on pelvic examination after removal of the stitch. Pregnancies were prolonged by a mean of 53 days in the cerclage group and 19 days in control women. The respective mean gestational ages at delivery were 37 and 31 weeks. Mean birth weights were substantially greater in the cerclage group (2549 g vs 1568 g). Eight of the 19 control pregnancies ended in perinatal death, but there were no such deaths in the 18 cerclage cases.These promising results deserve a large randomized, controlled trial that would distinguish between the effect of cerclage in women with minor and major placenta previa.