Nigeria 2007.

Methods	Single‐blinded randomised controlled study.
Participants	864 women with singleton, low‐risk pregnancies with anticipated spontaneous vertex delivery in a secondary health centre located in a semi‐urban area of Ibadan, capitol city of Oyo State. Exclusion criteria included the presence of contraindications to the use of either misoprostol and methylergometrine, such as pre‐eclampsia and other hypertensive diseases in pregnancy, pre‐existing cardiac disease, severe anaemia, history of asthma, renal or hepatic disorders, allergy to prostaglandins, and the presence of conditions requiring prophylactic oxytocin infusion after delivery such as grand multiparity, multiple pregnancy, polyhydramnios, previous history of postpartum haemorrhage and uterine fibroid.
Interventions	400 mcg of oral misoprostol versus 500 mcg of IM methylergometrine at the delivery of the anterior shoulder.
Outcomes	Total estimated blood loss (mL), postpartum haemorrhage (blood loss > 500 mL), duration of third stage of labour (min), duration of third stage of labour > 15 min, postdelivery packed cell volume (PCV) (%), differences in PCV (%), percentage changes in PCV (%), percentage PCV change > 10%, manual placental removal, additional oxytocics and side‐effects (fever, shivering, nausea, vomiting, headache).
Notes	Active management of third stage labour. Blood loss was estimated by a combination of careful measurement of blood collected in a receptacle after the delivery of the baby, visual estimation of blood loss and extrapolation of blood loss using weight difference of the total perineal pad used up to 24 hours in the postpartum period.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"An independent statistician generated sets of four random letters, which were in boxes, and each box contained four separate random allocations which was equivalent to an opaque sealed envelope stratified in a block for four."
Allocation concealment (selection bias)	Low risk	Adequate, see above.
Blinding (performance bias and detection bias) All outcomes	Low risk	"Single‐blinded."
Incomplete outcome data (attrition bias) All outcomes	Low risk	No loss to follow‐up or postrandomisation exclusions were reported.
Selective reporting (reporting bias)	Unclear risk	Not all of the primary outcomes of the review were reported.
Other bias	Low risk	None of the baseline variables are statistically significant between 2 groups.