Byaruhanga 2015.

Methods	Prospective parallel randomised controlled trial. Funding: Grand Challenges Canada provided funding for the trial (grant number CRS1 0018) and Laerdal Foundation for the training module ‘Helping Babies Survive Labour’ (grant number 40038).
Participants	Location: Nsambya teaching hospital in Kampala, Uganda. 1 centre. Inclusion criteria: women consented antenatal and reconfirmed in active labour. Women included were in established labour, with singleton pregnancy, cephalic presentation, > 37 weeks' gestation including post term, cervical dilation ≤ 7 cm, normal FHR on admission (120‐160). Exclusion criteria: women in second stage of labour or diagnosed as contraindicated for labouring when admitted (e.g. antepartum haemorrhage), intrauterine fetal death on admission or were having an elective caesarean. 1987 pregnant women were recruited.
Interventions	Women in established labour received either: Intermittent FHR auscultation with hand‐held wind‐up Doppler for 1 minute (60 seconds) immediately after a contraction: every 30 minutes in 1st stage, every 15 minutes in 2nd stage before pushing, and every 5 minutes in 2nd stage when pushing, (n = 1000, 992 included in the analysis) or, Intermittent FHR auscultation with a Pinard for 1 minute (60 seconds) immediately after a contraction for the same time frames as above (n = 978, 979 included in the analysis).
Outcomes	Primary outcomes: detection of FHR abnormality in labour (tachycardia > 160 bpm, bradycardia < 110 bpm, atypical variable, late or prolonged decelerations), intrapartum stillbirth and neonatal deaths in first 24 hours. Secondary outcomes: Apgar score < 7 at 5 minutes, admission to special care unit, diagnosis of neonatal encephalopathy (mild moderate or severe) and emergency caesarean section.
Notes	Emailed A. Montgomery (ann.montgomery@sickkids.ca), identified as corresponding author in the trial about the availability and access to further outcome data of the trial. Responded that she will talk to the team and come back, but this did not happened by date of review submission.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	‘Randomised’ equally to 1 of 2 groups, no other details.
Allocation concealment (selection bias)	Low risk	Sequentially numbered, opaque, sealed envelopes.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Participants and care providers were not blinded.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No details given.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Less than 1% attrition reported and reasons for losses were provided. 1987 enrolled; 987 to Pinard and 1000 to Doppler. Not analysed for Pinard n = 8 due to loss to follow‐up (n = 1), delivered before monitoring initiated (n = 1), breech birth (n = 2), multiple pregnancy (n = 2). For Doppler n = 8 not analysed; delivered before monitoring initiated (n = 3), breech birth (n = 3), multiple pregnancy (n = 2).
Selective reporting (reporting bias)	Low risk	All prespecified outcomes were reported.
Other bias	Low risk	No other risk of bias identified. Groups appeared balanced at baseline.