Matonhodze 2003.

Methods	RCT: Computer‐generated random sequence, sealed opaque envelopes.
Participants	Inclusion: completed 34 weeks GA, intact membranes Exclusion: uterine scar, uncontrolled medical complication, non‐vertex presentation, multiple pregnancy, fetal distress, APH.
Interventions	Foley catheter + misoprostol (n = 174): 50 mL, traction, max 24 hours, followed by oral misoprostol solution 20 mcg every 2 hours, 40 mcg 2‐hourly after 3 doses, until active labour had started. If after established labour contractions became inadequate: augmentation with misoprostol solution 5‐20 mcg hourly. If ineffective: oxytocin. Titrated oral misoprostol (n = 176): as described above Dinoprostone vaginal (n = 176). 2 mg in posterior fornix, repeated after 6 hours. If no active labour after 12 hours: oxytocin
Outcomes	Failed vaginal delivery within 24 hours, augmentation, tachysystole, hypersystole, hyperstimulation syndrome, tocolysis, analgesia, meconium, CS, instrumental delivery, maternal side effects, AS < 7, NICU admission, perinatal death, neonatal sepsis.
Notes	It is not clear if all patients had an unfavourable cervix (not mentioned in baseline characteristics. Data reported for different numbers of subjects depending on outcome (selective reporting or missing outcome data?). Setting: Pakistan Study period: October 2000 ‐ December 2001 Funding: not reported Declaration of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated random sequence,
Allocation concealment (selection bias)	Low risk	Sequentially‐numbered opaque, sealed envelopes out of a dispenser. intact membranes/unfavourable cervix, intact membranes/favourable cervix
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not feasible due to nature of intervention
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	ITT analysis, data reported for different numbers of subjects depending on outcome. not clear why
Selective reporting (reporting bias)	Low risk	All pre‐specified outcomes were reported in results
Other bias	Low risk	No other bias detected