Severe Hyperthermia With Altered Mental Status After Misoprostol Administration: Two Case Reports
Bibliographic record
Abstract
Misoprostol's low cost and temperature stable profile lends itself to widespread usage for postpartum hemorrhage (PPH). A common side effect is fever; however, this more rarely can present as a profound fever with altered mental status. We present two patients who received misoprostol for PPH, after which both had severe hyperthermia and altered mental status and were managed with sepsis protocol and anti-convulsants. These cases illuminate the importance of treatment selection in the management of uterine atony and subsequent steps of care of severe hyperthermia given the risk for adverse events. There needs to be awareness of this uncommon complication with administration of misoprostol. Supportive care and inclusion of the medication adverse effect in the broad differential are essential during presentation of the rare event of severe hyperthermia with altered mental status. It is important to be aware of this adverse effect with administration of more than 600 µg of misoprostol in the setting of PPH. J Clin Gynecol Obstet. 2023;12(3):106-109 doi: https://doi.org/10.14740/jcgo918
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.008 | 0.007 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".