- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03936322
Minimally Invasive Fetoscopic Regenerative Repair of Spina Bifida - A Pilot Study
January 25, 2021 updated by: Rodrigo Ruano M.D., Ph.D, Mayo Clinic
Researchers are studying a new minimally invasive technique (fetoscopic repair) for repair of spina bifida (MMC) during the second trimester of pregnancy.
Researchers are trying to determine if this less invasive surgical approach will have less risk to the mother and at the same time adequate closure of the fetal spina bifida defect.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
3
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Minnesota
-
Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria
- Pregnant women - maternal age 18 years or older
- Gestational age at the time of the procedure between 19 0/7 weeks and 25 6/7 weeks
- Singleton pregnancy.
MMC diagnosis with the upper boundary located between Thoracic 1 (T1) and Sacral
1 (S1).
- Evidence of hindbrain herniation (confirmed on MRI to have an Arnold-Chiari type II malformation).
- Absence of chromosomal abnormalities and associated anomalies.
- Normal karyotype and/or normal chromosomal microarray (CMA) by invasive testing (amniocentesis or CVS). If there is a balanced translocation with normal CMA with no other anomalies the candidate can be included.
- Family has considered and declined the option of termination of the pregnancy at less than 24 weeks.
- Family meets psychosocial criteria (sufficient social support, ability to understand requirements for this study).
- Pregnant subject capable of consenting for their own participation in this study.
- Willingness to undergo an open MMC repair, if necessary
- Parental/guardian permission (informed consent) for follow up of child after birth.
Exclusion Criteria:
Exclusion Criteria
- Fetal anomaly unrelated to MMC.
- Multiple gestation
- Declined invasive testing for karyotype (amniocentesis or CVS)
- Severe kyphosis (defined as curvature of the spina (vertebras) higher than 30o degree measured by ultrasonography or magnetic resonance imaging).
- Increased risk for preterm labor including short cervical length (<2.0 cm), history of incompetent cervix with or without cerclage, and previous preterm birth.
- Placental abnormalities (previa, abruption, accreta) known at time of enrollment.
- A body-mass index ≥40 at first prenatal visit.
- Contraindications to surgery including previous hysterotomy (whether from a previous classical cesarean, uterine anomaly such as an arcuate or bicornuate uterus, major myomectomy resection, or previous fetal surgery) in active uterine segment.
- Technical limitations precluding fetoscopic surgery, such as uterine fibroids, fetal membrane separation, uterine anomalies incompatible with fetoscopy.
- Amniotic Fluid Index (AFI) < 6 cm if deemed to be due to fetal anomaly, poor placental perfusion or function, or membrane rupture. Low amniotic fluid volume that responds to maternal hydration is not an exclusion.
- Maternal-fetal Rh isoimmunization, Kell sensitization or neonatal alloimmune thrombocytopenia affecting the current pregnancy.
- Maternal HIV, Hepatitis-B, Hepatitis-C status positive because of the increased risk of transmission to the fetus during maternal-fetal surgery. If the patients HIV or Hepatitis status is unknown, the patient must be tested and found to have negative results before enrollment.
- Maternal medical condition that is a contraindication to surgery or anesthesia.
- A score of ≥ 29 on the Beck Depression Inventory (BDI) at screening
- Maternal hypersensitivity to collagen
- Patient does not have a support person (i.e. Spouse, partner, mother) available to support the patient for the duration of the pregnancy.
- Inability to comply with the travel and follow-up requirements of the trial.
- Participation in another intervention study that influences maternal and fetal morbidity and mortality or participation in this trial in a previous pregnancy.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Pregnant women diagnosed with fetal myelomeningocele
Women subjects who are pregnant and diagnosed with myelomeningocele (MMC), also known as fetal spina bifida or neural tube defect, will undergo a minimally invasive fetoscopic repair of MMC.
|
Uses a technique to open your belly (skin, muscles and abdomen) without opening the uterus, except for a small puncture, to repair the fetal spina bifida defect during the second trimester of pregnancy.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Maternal adverse events
Time Frame: 5 years
|
Total number of maternal adverse events
|
5 years
|
Neonatal adverse events
Time Frame: 5 years
|
Total number of neonatal adverse events
|
5 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Helpful Links
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
May 7, 2019
Primary Completion (Anticipated)
June 1, 2023
Study Completion (Anticipated)
December 1, 2023
Study Registration Dates
First Submitted
May 1, 2019
First Submitted That Met QC Criteria
May 1, 2019
First Posted (Actual)
May 3, 2019
Study Record Updates
Last Update Posted (Actual)
January 27, 2021
Last Update Submitted That Met QC Criteria
January 25, 2021
Last Verified
January 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 18-008622
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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