Singh 2009.

Methods	Double‐blind randomised controlled trial. Computer‐generated randomisation and concealment of treatment group allocations were utilized.
Participants	Women presenting for delivery at the University College of Medical Sciences, Guru Teg Bahadur Hospital. Women with a healthy singleton pregnancy in spontaneous or induced labour at term were included. Women with the following were excluded: known hypersensitivity or contraindication to prostaglandins, fetal demise, antepartum haemorrhage, multiple pregnancy, malpresentation, cardiac disease, Rhesus‐negative mother, hypertensive disorders, and severe anaemia (Hb < 7 g/dL), and those requiring oxytocin until the second stage of labour.
Interventions	Immediately after delivery women received: A. oxytocin 5 IU IV (n = 75) or B. methylergometrine 0.2 mg IV (n = 75) All received the allocated drug as well as placebo for the other possible treatment drugs. All received placental cord traction until placental delivery. After infant delivery, a pre‐weighed linen and collection bag were placed beneath the patient and blood loss assessed by weight after 1 hour. Hb and Hct were recorded upon admission and 24 hours after delivery. There were 2 additional intervention arms in this trial that were not relevant to this review. 1 group received misoprostol 400 mcg sublingual, and the other received misoprostol 600 mcg sublingual.
Outcomes	Primary: blood loss during 3rd and 4th stage of labour Secondary: duration of 3rd stage, need for additional uterotonics, need for blood transfusion, adverse effects of drugs
Notes	Dates of study: unclear Funding sources: not reported Declarations of interest: none
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomised using quote: “computer‐generated random numbers.”
Allocation concealment (selection bias)	Low risk	Quote: “Drug packets were sealed and coded using a computer‐generated random number chart.”
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blinding of patients and personnel. Authors report "a duty nurse who was not involved in the study opened the allotted packet in a separate room." The patients and investigator were blinded to the packet contents. All patients received the study drug as well as placebo for the other interventions.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Double‐blinding of patients and personnel. Authors report "a duty nurse who was not involved in the study opened the allotted packet in a separate room." The patients and investigator were blinded to the packet contents. All patients received the study drug as well as placebo for the other interventions.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data.
Selective reporting (reporting bias)	High risk	Some adverse outcomes of interest are reported incompletely. Authors report “adverse effects of the drugs” as secondary outcomes, and in methods describe collection of data regarding postpartum Hb level,” however the data are not fully presented. They also report that “the methylergometrine group had the highest incidence of nausea and vomiting” but do not report the data completely.
Other bias	Unclear risk	Unclear.