Gomaa 2003.

Study characteristics
Methods	RCT
Participants	90 women Inclusion criteria: healthy pregnant women (25 to 40 years) undergoing elective caesarean under spinal anaesthesia Exclusion criteria: women known to be hypertensive Setting: Egypt
Interventions	Ephedrine versus phenylephrine versus control Group 1: ephedrine, 50 mg IM Group 2: phenylephrine, 4 mg IM Group 3: 2 mL saline IM All study drugs given 10 min before spinal anaesthesia All women received a standardised crystalloid preload and a standardised spinal anaesthetic technique and dose followed by standardised surgical positioning.
Outcomes	Maternal: hypotension Neonatal: cord/neonatal blood (reported as mean and SD); Apgar < 8 at 5 min (reported as mean and SD)
Notes	Hypotension was defined as 25% decrease in MAP from baseline
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method not described
Allocation concealment (selection bias)	Unclear risk	Method not described
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Blinding: drugs were prepared by an anaesthetic assistant not involved in the study and injected by an anaesthetist not involved in data collection or care of the women
Blinding of outcome assessment (detection bias) All outcomes	Low risk	As above
Incomplete outcome data (attrition bias) All outcomes	Low risk	Losses to follow‐up: not stated but losses unlikely
Selective reporting (reporting bias)	Low risk	Not apparent
Other bias	Low risk	Not apparent