Balki 2008

Methods	2‐arm active‐controlled double‐blinded randomised trial.
Participants	Between 12th June 2005 and 18th December 2006, 48 parturients were randomised in a hospital setting in Canada. The population comprised women of unspecified parity, a singleton pregnancy, at high risk for PPH, who delivered by emergency caesarean section. Exclusion criteria comprised parturients requiring general anaesthesia, or those with cardiac disease, hypertension or any condition predisposing to uterine atony and PPH, such as placenta praevia, multiple pregnancy, pre‐eclampsia, macrosomia, polyhydramnios, uterine fibroids, bleeding disorders, chorioamnionitis, previous uterine atony, previous PPH or allergy/hypersensitivity to oxytocin or ergot derivatives.
Interventions	250 mcg plus 20 IU of ergometrine plus oxytocin administered by an intravenous bolus (n = 24) versus 20 IU of oxytocin administered by an intravenous bolus plus infusion (n = 24).
Outcomes	The study recorded the following outcomes: additional uterotonics, transfusion, blood loss (mL), nausea, vomiting, hypertension, tachycardia. hypotension.
Notes	Contact with study authors for additional information: yes. Additional data from authors: no.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation was achieved using a computer‐generated list of numbers.
Allocation concealment (selection bias)	Low risk	Investigators used consecutively‐numbered opaque sealed packets or envelopes.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Study participants and caregivers were blinded to treatment allocations.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Assessors were blinded to treatment allocations.
Objective assessment of blood loss	High risk	Investigators evaluated blood loss by measurement of haematocrit preoperatively and 48 hours postoperatively.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Data were collected completely from all randomised study participants.
Selective reporting (reporting bias)	Unclear risk	The protocol of the study was unavailable for verification.
Intention to treat analysis	Low risk	All those who were enrolled and randomly allocated to treatment were included in the analysis, in the groups to which they were randomised.
Funding source	Low risk	The study was supported by funding from the institution of the authors.