Crohn's disease (CD) is a chronic inflammatory bowel disease preferentially affecting women of childbearing age with a first peak incidence in the third decade of life [1]. An impact of CD on pregnancy outcomes has been shown, with increased incidence of preterm delivery and small for gestational age [2,3]. Some studies have suggested increased risk of fetal death in utero [4] or congenital malformations [5]. Some medications used to treat CD may also have an impact on pregnancy [6,7,8].

There has been less study of delivery outcomes, although high cesarean section rates have been reported in patients with CD [9,10] and there is little evidence on the preferable mode of delivery. The disease can result in malnutrition, scarring perineal lesions, ano-rectal surgical procedures or chronic intestinal inflammation, which may be risk factors for perineal complications in case of vaginal delivery. Conversely, in case of multiple surgical history, performing a cesarean section may be more complex. The existence of ano-perineal lesions would be an indication for planned cesarean section, but the literature remains little detailed on their type or their importance [9,11,12].

The French College of Gynecologists and Obstetricians (CNGOF) [13] recommended that cesarean section should be decided mainly for obstetrical reasons, taking into consideration the presence of active perineal lesions [10,14].

The main objective of our study was to describe the impact of Crohn's disease on the management of childbirth, particularly the indications for cesarean section.