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Føtoskopisk endoluminal tracheal okklusion (FETO)

4. november 2026 opdateret af: Children's Hospitals and Clinics of Minnesota

Føtoskopisk endoluminal trakealokklusion for svær venstresidet medfødt diafragmabrok

This is a single site pilot trial to study the feasibility of Fetoscopic Endoluminal Tracheal Occlusion (FETO) therapy in the most severe group of fetuses with congenital diaphragmatic hernia (CDH) at Midwest Fetal Care Center, a collaboration between Allina Health and Children's Minnesota. This procedure aims to increase fetal lung volume before birth and improve survival after birth. This study will enroll 10 pregnant people and their baby who meet study criteria.

Studieoversigt

Status

Trukket tilbage

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a single site pilot trial to assess the feasibility and safety of treating the most severe group of fetuses with left CDH with Fetal Endoluminal Tracheal Occlusion (FETO) using the Goldballoon Detachable Balloon (GOLDBAL2) along with the Delivery Microcatheter (BALTACCI-BDPE100) at Midwest Fetal Care Center (MWFCC), a collaboration between Allina Health and Children's MN.

Congenital Diaphragmatic Hernia (CDH) is a condition in which a hole in the baby's diaphragm allows the abdominal organs to move into the chest and limit lung growth. The goal of the FETO device is to block the airway with a balloon-type device, allowing fluid to build up in the lungs and help the unborn baby's lungs grow. Bigger lungs may improve the baby's quality of life. The rationale for fetal therapy in severe CDH is to improve fetal lung growth and therefore neonatal survival.

The study will enroll pregnant women that meet study criteria, and their baby. The mother-fetus participant will undergo one procedure for placement of FETO before gestational age 29 weeks 6 days; and a second procedure for removal of the FETO device. The timing for removal of FETO is no later than 35 weeks and 6 days. After delivery, routine care of the baby with CDH will occur within the Children's MN NICU.

Undersøgelsestype

Interventionel

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55404
        • Midwest Fetal Care Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

Inclusion Criteria:

  1. A subject is defined as a female (18 years or older) who is pregnant.
  2. The pregnancy must be a singleton pregnancy.
  3. The CDH must be left-sided.
  4. The CDH must be severe (Observed to Expected Lung to Head Ratio - O/E LHR - < 25% from U/S measurements).
  5. No associated lethal anomalies (other than the CDH), no pathogenic variants on microarray, and no pathologic findings on karyotype.
  6. Fetal echocardiogram with changes expected with CDH and no major structural cardiac defects.
  7. Gestational age at time of balloon placement between and including 27 weeks 0 days and 29 weeks 6 days.
  8. Cervix length longer than 20 mm at pre-balloon placement evaluation.
  9. Acceptance of responsibility to stay locally (within 15 minutes) of MWFCC and Children's Minnesota - Minneapolis.
  10. Written consent must be obtained.
  11. Must meet psychosocial criteria including appropriate family/friend support during stay with balloon in place (cannot stay without additional helper), no current illicit drug use, no over-the-counter drug abuse, and no ineffectively treated DSM-IV diagnoses.

Exclusion Criteria:

  1. Twin or higher order gestation
  2. Not able to consent
  3. Right-sided or bilateral CDH
  4. Additional fetal or genetic abnormalities that would impact care after delivery or be known to have an impact on outcome
  5. Maternal isoimmunization or neonatal alloimmune thrombocytopenia
  6. Balloon not able to be placed prior to 30 weeks gestation
  7. CDH O/E LHR 25% or greater
  8. Maternal factors precluding safe fetal surgery (maternal cardiac findings not safe for anesthesia, maternal morbid obesity precluding safe usage of the equipment required for entry into the uterus, spontaneous preterm delivery prior to 36 weeks)
  9. Maternal HIV, Hepatitis B with positive surface antigen, Hepatitis C with presence of virus in maternal blood due to risks of fetal transmission during procedures
  10. Short cervix (20 mm or less)
  11. History of incompetent cervix or uterine anomaly predisposing to preterm labor
  12. Significant placental abnormalities (abruption, chorioangioma, accrete) known at the time of enrollment and/or surgery
  13. History of natural rubber latex allergy
  14. No safe or feasible fetoscopic approach to balloon placement
  15. Inability to relocate to within 15 minutes of MWFCC/Children's Minnesota

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Enhedens gennemførlighed
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: FETO therapy

FETO therapy

placement of FETO prior to 29 weeks 6 days GA; and removal of the FETO device no later than 35 weeks and 6 days

Andre navne:
  • Føtoskopisk endoluminal tracheal okklusion
  • GULDBALLON
  • BALTACCI

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Successful placement of Balt Goldbal2 balloon
Tidsramme: Prior to 29 weeks 6 days Gestational Age (GA)

Successful completion of balloon insertion in fetuses with severe CDH defined as direct visualization of balloon above the carina at the time of FETO procedure.

Prior to 29 weeks 6 days Gestational Age (GA)
Successful removal of Balt Goldbal2 balloon
Tidsramme: Prior to 35 weeks 6 days GA

Removal of the balloon

Prior to 35 weeks 6 days GA

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in fetal lung growth
Tidsramme: Immediately after intervention (device removal)

Prenatal ultrasound will measure the observed-to-expected lung to head ratio (o/e LHR) at weekly visits while the balloon is in place and after balloon removal. Fetal lung growth will be calculated as the difference between the o/e LHR pre-balloon placement and the o/e LHR after balloon removal.

Immediately after intervention (device removal)
Gestational age at delivery
Tidsramme: Measured at time of delivery

Gestational age at delivery will be recorded.

Measured at time of delivery
Infant survival
Tidsramme: Birth - 24 months

Infant survival will be recorded from delivery to NICU discharge, and at 6, 12, and 24 months of age

Birth - 24 months
Number of infants requiring extra corporeal membrane oxygenation (ECMO) support
Tidsramme: Birth to 6 months

Use of ECMO will be collected from medical chart review.

Birth to 6 months
Number of infants requiring tracheostomy while in the NICU
Tidsramme: up to 2 years of age

Tracheostomy information will be collected from medical chart review.

up to 2 years of age
Number of infants requiring home oxygen support upon discharge from the NICU
Tidsramme: up to 2 years of age

Oxygen support will be collected from medical chart review.

up to 2 years of age
Time to pulmonary hypertension resolution
Tidsramme: up to 2 years of age

pulmonary hypertension will be collected from medical chart review.

up to 2 years of age

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

22. februar 2024

Primær færdiggørelse (Faktiske)

28. februar 2026

Studieafslutning (Faktiske)

28. februar 2026

Datoer for studieregistrering

Først indsendt

16. februar 2023

Først indsendt, der opfyldte QC-kriterier

14. marts 2023

Først opslået (Faktiske)

16. marts 2023

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. februar 2024

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 1397678; 2021-055

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ja

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