Fetoscopic Meningomyelocele Repair Study (fMMC)
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|ClinicalTrials.gov Identifier: NCT02230072|
Recruitment Status : Active, not recruiting
First Posted : September 3, 2014
Last Update Posted : April 5, 2022
The purpose of the study is to evaluate the maternal and fetal outcomes of a new technique for the fetoscopic repair of fetal MMC at Texas Children's Hospital Pavilion for Women.
The investigators hypothesis is that this minimally invasive technique is feasible, and that this approach will have the same efficacy as open fetal surgery for MMC, but with significantly less maternal-fetal risk. Both mother and baby will benefit from the surgery. The fetus will have a repaired MMC defect, and the mother will not have a uterine incision (hysterotomy). A hysterotomy increases the risk of uterine rupture and requires that all subsequent deliveries are by cesarean section. There may also be a decreased risk of Pre-term Premature Rupture Of Membranes (PPROM) and prematurity when compared with the current open operation. Finally, a vaginal delivery is possible following the fetoscopic fetal surgery if the baby is shown to have a skin covered repair.
|Condition or disease||Intervention/treatment||Phase|
|Neural Tube Defect||Device: fetoscopy||Phase 1|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||60 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Minimally Invasive Fetal Neural Tube Defect Repair Study|
|Actual Study Start Date :||July 2014|
|Estimated Primary Completion Date :||March 2024|
|Estimated Study Completion Date :||March 2024|
Experimental: fetoscopic surgical repair
Single arm study. All patients will receive the fetoscopic repair.
The fetoscopic arm is described above. All patients will have a laparotomy, exteriorization of the uterus, and a fetoscopic repair of the fetal open neural tube defect.
- Feasibility [ Time Frame: Time of procedure ]Whether the minimally invasive technique can be technically performed in human patients (success of primary skin closure) in a safe and effective manner.
- Reversal of the Chiari II malformation with complete closure of the spinal defect. [ Time Frame: at birth ]Whether the minimally invasive technique results in an acceptable fetal outcome as defined by reversal of the Chiari II malformation, a reduced need for ventriculoperitoneal shunting or other procedures to avoid or treat hydrocephalus, and complete closure of the spinal defect with protection of the placode. In addition the procedure will be assessed as to whether it prevents loss of neurological level during intra-uterine life.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02230072
|United States, California|
|Stanford University: Lucille Packard's Childrens Hospital|
|Stanford, California, United States, 94305|
|United States, Texas|
|Texas Childrens Hospital|
|Houston, Texas, United States, 77030|
|Principal Investigator:||Michael A. Belfort, M.D.||Baylor College of Medicine|