RECRUITING

Fetoscopic Neural Tube Defect Repair

Conditions

Neural Tube Defects Spina Bifida Fetal Surgery Fetoscopy

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This is a single-arm prospective study to record maternal and neonatal outcomes on subjects who undergo fetoscopic repair of Neural Tube Defects (NTD) at Oregon Health \& Science University (OHSU). Fetoscopic repair will take place between 24 weeks 0 days and 27 weeks 6 days gestation. Surgical, post-operative, delivery, and neonatal outcomes will be collected.

Official Title

Fetoscopic Neural Tube Defect Repair: Observational Pilot Study

Quick Facts

Study Start:2023-04-01

Study Completion:2033-04

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT06946563

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.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:FEMALE

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Maternal age 18 years or older * Capable of consenting for their own participation in the study * Decision to have fetoscopic repair following counseling of all options * Open spina bifida with the upper boundary between T1 and S1 * Gestational age between 24 0/7 to 26 6/7 weeks' gestation at the time of surgery * Normal karyotype and/or normal chromosomal microarray by invasive testing. In the case of a microdeletion, microduplication, or variant of uncertain significant, the decision to include or exclude will be at the discretion of the Principal Investigators. * Absence of major cardiac anomalies confirmed by fetal echocardiogram * Adequate social support throughout pregnancy * Parental or guardian willingness to undergo follow-up evaluations of the child after birth	* Multiple gestation * Major fetal anomalies unrelated to the neural tube defect * Kyphosis in fetus of 30 degrees or more as assessed by ultrasound or MRI * Previous spontaneous singleton preterm birth prior to 37 weeks * Presence of cervical cerclage at the time of surgery or history of cervical insufficiency * Cervical length less than 20 mm by endovaginal ultrasound * Placenta previa or evidence of placental abruption * Technical factors such as large uterine fibroids, uterine anomalies, or fetal membrane separation for which the risks of surgery are deemed to outweigh the benefits * Maternal obesity precluding surgical access with a BMI \> 45 or if the Principal Investigator determines the body habitus to be technically challenging * Alloimmunization in pregnancy including Kell sensitization or a history of neonatal alloimmune thrombocytopenia * Maternal HIV or Hepatitis B positive status. If the patient's HIV or Hepatitis B status is unknown, the patient must be tested and found to be negative prior to surgery * Known Hepatitis C positivity. If the patient's Hepatitis C status is known, they do not need to be screened * Maternal medical condition which is a contraindication to surgery or general anesthesia. This includes previous hysterotomy in the active segment of the uterus * Maternal medical co-morbidities which would significantly increase the risk of spontaneous or iatrogenic preterm delivery * Inability of the patient to comply with travel and follow-up requirements of the study * Patient not meeting psychosocial criteria determined by fetal care social worked to comply with the medical care and plan for follow ups * Participation in another interventional study that influences maternal and fetal morbidity and mortality * Known history of hypersensitivity to collagen products or chondroitin materials

Inclusion Criteria

Exclusion Criteria

* Maternal age 18 years or older
* Capable of consenting for their own participation in the study
* Decision to have fetoscopic repair following counseling of all options
* Open spina bifida with the upper boundary between T1 and S1
* Gestational age between 24 0/7 to 26 6/7 weeks' gestation at the time of surgery
* Normal karyotype and/or normal chromosomal microarray by invasive testing. In the case of a microdeletion, microduplication, or variant of uncertain significant, the decision to include or exclude will be at the discretion of the Principal Investigators.
* Absence of major cardiac anomalies confirmed by fetal echocardiogram
* Adequate social support throughout pregnancy
* Parental or guardian willingness to undergo follow-up evaluations of the child after birth

* Multiple gestation
* Major fetal anomalies unrelated to the neural tube defect
* Kyphosis in fetus of 30 degrees or more as assessed by ultrasound or MRI
* Previous spontaneous singleton preterm birth prior to 37 weeks
* Presence of cervical cerclage at the time of surgery or history of cervical insufficiency
* Cervical length less than 20 mm by endovaginal ultrasound
* Placenta previa or evidence of placental abruption
* Technical factors such as large uterine fibroids, uterine anomalies, or fetal membrane separation for which the risks of surgery are deemed to outweigh the benefits
* Maternal obesity precluding surgical access with a BMI \> 45 or if the Principal Investigator determines the body habitus to be technically challenging
* Alloimmunization in pregnancy including Kell sensitization or a history of neonatal alloimmune thrombocytopenia
* Maternal HIV or Hepatitis B positive status. If the patient's HIV or Hepatitis B status is unknown, the patient must be tested and found to be negative prior to surgery
* Known Hepatitis C positivity. If the patient's Hepatitis C status is known, they do not need to be screened
* Maternal medical condition which is a contraindication to surgery or general anesthesia. This includes previous hysterotomy in the active segment of the uterus
* Maternal medical co-morbidities which would significantly increase the risk of spontaneous or iatrogenic preterm delivery
* Inability of the patient to comply with travel and follow-up requirements of the study
* Patient not meeting psychosocial criteria determined by fetal care social worked to comply with the medical care and plan for follow ups
* Participation in another interventional study that influences maternal and fetal morbidity and mortality
* Known history of hypersensitivity to collagen products or chondroitin materials

Contacts and Locations

Study Contact

Women's Health Research Unit Department of Ob/Gyn

CONTACT

503-494-3666

whru@ohsu.edu

Principal Investigator

Raphael Sun, MD

PRINCIPAL_INVESTIGATOR

Oregon Health and Science University

Andrew Chon

PRINCIPAL_INVESTIGATOR

Oregon Health and Science University

Study Locations (Sites)

Oregon Health & Science University

Portland, Oregon, 97239

United States

Collaborators and Investigators

Sponsor: Oregon Health and Science University

Raphael Sun, MD, PRINCIPAL_INVESTIGATOR, Oregon Health and Science University
Andrew Chon, PRINCIPAL_INVESTIGATOR, Oregon Health and Science University

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 Registration Dates

Study Start Date2023-04-01

Study Completion Date2033-04

Study Record Updates

Study Start Date2023-04-01

Study Completion Date2033-04

Terms related to this study

Keywords Provided by Researchers

Fetal Surgery
Fetoscopy

Additional Relevant MeSH Terms

Neural Tube Defects
Spina Bifida