September 2018 Question 1

Q1. Correct Answer: D 
 
Rationale  
There is a risk of perineal trauma with vaginal delivery, and therefore, patients with active perianal Crohn's disease should undergo cesarean delivery to avoid exacerbation of disease. Patients without a history of perianal disease or those with inactive perianal disease have a low rate of relapse, and cesarean delivery is not warranted. Aside from patients with active perineal disease, the mode of delivery should be left to the discretion of the obstetrician. None of the other choices above, including ileal pouch-anal anastomosis, justify the decision to perform cesarean section.