Laparotomy Versus Percutaneous Endoscopic Correction of Myelomeningocele

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age18+
SponsorUSFetus

About this trial

The purpose of this study is to evaluate the feasibility of a fetoscopic surgical technique for antenatal correction of fetal myelomeningocele. Two surgical approaches will be utilized. The percutaneous approach will be offered to participants with a posterior placenta. The laparotomy/uterine exteriorization approach will be offered to participants regardless of placental location.

Eligibility criteria

Qualifiers

Myelomeningocele (including myeloschisis) at level T1 through S1 with hindbrain herniation. Lesion level and hindbrain herniation will be confirmed by MRI and ultrasonography.

Maternal age ≥18 years.

Gestational age of 19 to 27 6/7 weeks' gestation as determined by clinical information and evaluation of first ultrasound.

Balanced karyotype with written confirmation of culture results. Results by fluorescence in situ hybridization (FISH) will be acceptable if the patient is at 24 weeks or more.

Disqualifiers

Multiple gestation

Insulin-dependent pregestational diabetes

Presence of a fetal anomaly not related to myelomeningocele. A fetal echocardiogram will be conducted before surgery and if the finding is abnormal, the patient will be excluded.

Fetal kyphosis of 30 degrees or more, assessed by ultrasound or MRI.

Trial design

Treatments tested in this trial

  • Fetoscopy

Treatment groups

12 Participants
are divided into 1 treatment group

Sponsors and collaborators

USFetus

Lead sponsor

Wellington Hospital

Collaborator

University of Southern California

Collaborator