Summary of findings 3. Oxytocin + ergometrine compared to ergot alkaloids for the third stage of labour to prevent postpartum haemorrhage.

Oxytocin + ergometrine compared to ergot alkaloids for the third stage of labour to prevent postpartum haemorrhage
Patient or population: women in the third stage of labour Setting: hospital labour wards in Sweden, Singapore, Tunisia, and the UK Intervention: oxytocin + ergometrine Comparison: ergot alkaloids
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with ergot alkaloids	Risk with oxytocin + ergometrine
Blood loss 500 mL or more after delivery	Study population		RR 0.44 (0.20 to 0.94)	1168 (3 RCTs)	⊕⊕⊝⊝ LOW 1 2
	37 per 1000	16 per 1000 (7 to 34)
Need for additional uterotonics	Study population		‐	‐	‐	This outcome was not reported in any of the included studies.
	‐	‐
Maternal all‐cause mortality	Study population		not estimable	807 (1 RCT)	⊕⊕⊕⊝ MODERATE 3	It was not possible to obtain effect estimates as there were no events reported.
	0 per 1000	0 per 1000 (0 to 0)
Blood loss 1000 mL or more after delivery	Study population		‐	‐	‐	This outcome was not reported in any of the included studies.
	‐	‐
Blood transfusion	Study population		‐	‐	‐	This outcome was not reported in any of the included studies.
	‐	‐
Third stage > 30 minutes	Study population		‐	‐	‐	This outcome was not reported in any of the included studies.
	‐	‐
Diastolic blood pressure > 100 mm Hg between delivery of the baby and discharge from the labour ward	Study population		‐	‐	‐	This outcome was not reported in any of the included studies.
	‐	‐
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio;
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

¹ Lack of blinding of estimated outcome assessment, and concern regarding randomisation methods (risk of bias ‐1)

² Few events and wide 95% confidence intervals (imprecision ‐1)

³ No events reported for this outcome (imprecision ‐1)