Methods: Nulliparous women with term pregnancies and single cephalic presentation, presenting with the spontaneous rupture of membranes and active phase of labor, were enrolled in this study. The AFL was evaluated by a portable device. In addition, the partogram curve, labor progression, and delivery method were recorded for each patient. Finally, the association between the need for cesarean delivery and the AFL level was investigated as well.

Results: In general, 200 nulliparous pregnant women were enrolled in this study. The mean age of women and the mean AFL were 29.12 ± 7.54 years and 7.32 ± 3.63 mmol/L, respectively. Among 144 patients with AFL below 10.1 mmol/L, 33 patients (22.9%) had a cesarean delivery. Further, among 56 patients with AFL above 10.1 mmol/L, 42 patients (75%) had a cesarean delivery (P < 0.001). Eventually, an AFL level higher than 10.1 mmol/L in predicting the cesarean section had a sensitivity of 85.6% and a specificity of 82.7%.

Conclusions: Amniotic lactate levels >10.1 mmol/L in nulliparous women with single-term pregnancy can be used as a marker for predicting cesarean delivery.