Rivard 2012.

Methods	RCT or quasi‐RCT: RCT Setting: USA Period: July 2009 – November 2009
Participants	Population: singleton pregnancies in active labour or undergoing induction of labour who were anticipated to have vaginal delivery Inclusion criteria: adult women (age > 18) with a singleton pregnancy who presented to the labour and delivery unit in active labour or for labour induction, were anticipated to have a vaginal delivery, and chose epidural for pain control Exclusion criteria: scheduled for caesarean delivery, had multi‐fetal gestations, required tocolysis, and/or were on magnesium prophylaxis Age (mean): A: 27.6; B: 28.7 Number of participants: · Eligible: 139 · Randomised: 139 · Reported: 138 Dropouts (n of participants + reasons): 1 in intermittent catheter group due to physician withdrawal Follow‐up: duration of labour
Interventions	Time of intervention: Enrolled participants randomised after physician determined clinical need for catheterisation A (n = 72): indwelling catheter. Removed during 2nd stage of labour when woman started pushing B (n = 67): intermittent catheter inserted every 2 to 4 hours Intended duration of catheterisation: A: until 2nd stage of labour B: unclear
Outcomes	Primary outcome (symptomatic UTI): not reported Definition of symptomatic UTI: not reported Bacteriuria: not reported Definition of bacteriuria: not reported Cost per catheter: A: USD 6.28; B: USD 5.98 Number of catheterisations (mean, SD not reported, n): A: NR; B: 2.5 Nurses’ perceptions: Preference: A: 30/37; B: 7/37 *Better care: A: 28/37; B: 9/37 **Time requirement: A: 31/37; B: 6/37 Preference for method to be standard care: A: 34/37; B: 2/37 Quality of life: Not reported
Sponsorship/Funding	“No financial disclosures”
Notes	*Nurses’ perception of care they provide to patients **i.e. nurses perceived A (indwelling) to be less time‐consuming Not reported if used prophylactic antibiotics
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	“computer‐generated list of randomization using permuted block” – adequate method of randomisation
Allocation concealment (selection bias)	Low risk	“Sequentially numbered opaque envelopes displaying only the randomization number on the outside” – low risk of allocation of intervention being revealed
Blinding of participants	High risk	No information given on blinding of participants. Can assume that blinding did not occur as indwelling vs intermittent
Blinding of personnel	High risk	No information given on blinding of personnel. As indwelling vs intermittent can assume blinding did not occur
Blinding of microbiological outcome assessment	Low risk	Microbiological outcomes not reported, therefore no risk of bias from reporting of microbiological outcomes
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No information given
Incomplete outcome data (attrition bias) All outcomes	Low risk	146 enrolled, 7 excluded (2 magnesium prophylaxis, 2 no epidural, 3 delivered prior to randomisation). 139 randomised, 72 indwelling, 67 intermittent 1 withdrawn from intermittent due to physician recommendation. 72 indwelling, 66 intermittent None lost to follow‐up
Selective reporting (reporting bias)	Low risk	All outcomes were reported in the Results. Unable to access protocol, so uncertainty surrounding selective reporting
Other bias	Low risk	Appears to be free of other sources of bias