Methods	Randomization was accomplished by alternating women to aggressive management or control groups
Participants	150 women (n = 75 in each group). Inclusion criteria: 37-42 weeks’ gestation; uterine contractions accompanied by cervical dilatation of 3 cm or ruptured membranes; less than 3 contractions lasting 40 seconds each in a 10-minute time period
Interventions	Early aggressive management: amniotomy if required, and oxytocin infusion. This was accomplished within 30 minutes of the admission. Initial oxytocin infusion rate:1 mU/ minute and increased by 1 mU/minute every 30 minutes until adequate contraction pattern was achieved. Control group: usual care.
Outcomes	Maternal characteristics; cervical dilatation; effacement %; caesarean delivery; instrumental and spontaneous vaginal deliveries; duration of labour; Apgar score at 1 and 5 minutes; cord pH; birthweight
Notes	Prevention trial. Nulliparous women.
Risk of bias
Bias	Authors’ judgement	Support for judgement
Random sequence generation (selection bias)	High risk	Quasi-randomization by alternating women.
Allocation concealment (selection bias)	High risk	The women were allocated by alternate assignment.
Blinding of participants and personnel (performance bias) All outcomes	High risk	The participants were not blinded to the treatment.
Blinding of outcome assessment (detection bias) All outcomes	High risk	The clinicians were not blinded to the treatment.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	No information on numbers of postpartum women followed up.
Selective reporting (reporting bias)	Low risk	Main outcomes reported.
Other bias	Unclear risk	No information on eligible women.