Ng 2007

Methods	2‐arm active‐controlled double‐dummy randomised trial.
Participants	Between April 2000 and January 2001, 360 parturients were randomised in a hospital setting in Hong Kong. The population comprised women of parity 3 or less, a singleton pregnancy, at low risk for PPH, who delivered by vaginal delivery. Exclusion criteria comprised parturients requiring oxytocin infusion in the third stage, or those with pre‐eclampsia, cardiac disorder, asthma, grand multiparity (more than 3), fibroids or contraindications for the use of either misoprostol or syntometrine.
Interventions	400 mcg of misoprostol administered orally (n = 178) versus 500 mcg plus 5 IU of ergometrine plus oxytocin administered intramuscularly (n = 177). There were 5 exclusions post randomisation but it was unclear from which group.
Outcomes	The study recorded the following outcomes: PPH at 500, PPH at 1000, morbidity, additional uterotonics, transfusion, manual removal of placenta, death, blood loss (mL), change in Hb level, nausea, vomiting, hypertension, headache, fever, shivering.
Notes	Contact with study authors for additional information: no. Additional data from authors: no.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation was based on a table of computer‐generated random numbers.
Allocation concealment (selection bias)	Low risk	Investigators used consecutively‐numbered and sealed opaque packages.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	"The placebo was identical in size and colour but had a different shape to the misoprostol tablet. All women were asked to swallow the tablets directly from the opaque cup without looking at them. The identity of the active medication and placebo were concealed from the caregivers and the parturient."
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 the estimation of attending physicians.
Incomplete outcome data (attrition bias) All outcomes	Low risk	"5 women were excluded from the analysis because of missing post‐delivery haemoglobin level."
Selective reporting (reporting bias)	Unclear risk	The protocol of the study was unavailable for verification, but not all of the outcomes projected by methodological descriptions were reported as results in the study report (cases of tachycardia and dizziness were omitted).
Intention to treat analysis	High risk	Those who withdrew from the study after randomisation were not included in the analysis.
Funding source	Unclear risk	Source(s) of funding for the study were not reported.