Alimian 2014.

Study characteristics
Methods	RCT
Participants	90 women undergoing elective caesarean section Inclusion criteria: normal single pregnancy, gestational age > 37 weeks, no history of hypertension Exclusion criteria: contraindications for spinal anaesthesia, third trimester bleeding, BMI > 30 kg/m², previous allergy to hydroxyethyl starch (HES) preparations, known cardiomyopathy, height < 155 cm, sympathetic block higher than T4 Setting: France and USA
Interventions	Ringer's lactate preload vs sodium chloride preload vs HES preload Group 1: Ringer's lactate group, 1000 mL Group 2: sodium chloride 0.9% group, 1000 mL Group 3: HES group, 7.5 mL/kg
Outcomes	Maternal: BP, heart rate Neonatal: umbilical cord pH, Apgar score
Notes	Hypotension was defined as a drop in systolic blood pressure of > 20% from baseline or systolic blood pressure < 100 mmHg.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Block randomisation technique
Allocation concealment (selection bias)	Unclear risk	Not reported
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	"Double blind" – no further detail provided
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	"Double blind" – no further detail provided
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Not reported
Selective reporting (reporting bias)	Low risk	Most expected outcomes reported
Other bias	Low risk	None evident