ClinicalTrials.gg
CompletedNCT03936322Updated Feb 24, 2025Results posted

Minimally Invasive Fetoscopic Regenerative Repair of Spina Bifida - A Pilot Study

An interventional study of Minimally invasive fetoscopic repair of MMC in Spina Bifida, Myelomeningocele and Neural Tube Defects, sponsored by Rodrigo Ruano. Completed at 1 site in United States. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-02-24.

Sponsored by Rodrigo Ruano · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
3
Allocation
Not applicable
Ages
18 Years and older
Sex
Female
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Study summary

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.

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Conditions studied

  • Spina Bifida
  • Myelomeningocele
  • Neural Tube Defects
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In context

Spinal Dysraphism

142 studies on the registry are indexed under Spinal Dysraphism; 39 are open to participants now.

This study's enrollment of 3 is below the median of 30 across 91 interventional studies indexed under Spinal Dysraphism.

Browse Spinal Dysraphism studies →

Lead sponsor

Rodrigo Ruano is the lead sponsor of 3 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Eligibility criteria

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 () 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.
    • 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 , 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 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.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
3 participants (actual)

Study arms

  • 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.

    Device: Minimally invasive fetoscopic repair of MMC

Interventions

  • DeviceMinimally 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.

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What researchers measure

Primary outcomes

  1. Maternal Adverse Events

    Total number of maternal adverse events

    Time frame: From time of surgery until delivery (up to 21 weeks)

  2. Neonatal Adverse Events

    Total number of neonatal adverse events

    Time frame: From the time of surgery until 28 days of life (up 25 weeks)

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Results

Posted Feb 24, 2025

Participant flow

Participant flow — Overall Study
MilestonePregnant Women Diagnosed With Fetal Myelomeningocele
Started3
Completed1
Not completed2
Withdrew: Lost to follow-up1
Withdrew: Infant death after delivery; therefore, no further follow up occurred1

Outcome measures

PrimaryMaternal Adverse Events

Total number of maternal adverse events

Time frame:
From time of surgery until delivery (up to 21 weeks)
Reported as:
Number · participants
Maternal Adverse Events
participantsPregnant Women Diagnosed With Fetal Myelomeningocele
Maternal Adverse Events2
PrimaryNeonatal Adverse Events

Total number of neonatal adverse events

Time frame:
From the time of surgery until 28 days of life (up 25 weeks)
Reported as:
Number · participants
Neonatal Adverse Events
participantsPregnant Women Diagnosed With Fetal Myelomeningocele
Neonatal Adverse Events1

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Pregnant Women Diagnosed With Fetal Myelomeningocele0/3 (0%)1/3 (33.3%)1/3 (33.3%)
Most frequent serious events
Most frequent serious events
EventPregnant Women Diagnosed With Fetal Myelomeningocele
Placenta abruption/neonatal demisePregnancy, puerperium and perinatal conditions1/3
Most frequent other events
Most frequent other events
EventPregnant Women Diagnosed With Fetal Myelomeningocele
premature rupture of the membranesPregnancy, puerperium and perinatal conditions1/3

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Pregnant Women Diagnosed With Fetal Myelomeningocele
<=18 years0
Between 18 and 65 years3
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Pregnant Women Diagnosed With Fetal Myelomeningocele
Female3
Male0
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Pregnant Women Diagnosed With Fetal Myelomeningocele
Hispanic or Latino1
Not Hispanic or Latino2
Unknown or Not Reported0
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Study locations

1 site
  • Mayo Clinic in Rochester
    Rochester, Minnesota 55905, United States
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References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

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Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from May 2019 to primary completion in Jun 2024, 61 months.

Results were first posted in Feb 2025, 7 months after primary completion.

Of 60 non-industry interventional studies with no phase under Spinal Dysraphism, half reached primary completion within 31 months of starting (the median), counting those still running; a quarter within 20 and three quarters within 57. This study's 61 months is above that.

Counting every sponsor, half of 62 studies reached it within 31 months; a quarter within 20 and three quarters within 57.

How these figures are worked out, and which studies are left out of them.

Registered
May 1, 2019
First posted
May 3, 2019
StartActual
May 7, 2019
Primary completionActual
Jun 30, 2024
CompletionActual
Jun 30, 2024
Results first posted
Feb 24, 2025
Last update
Feb 24, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 24, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03936322
Lead sponsor
Rodrigo Ruano
Collaborators
Mayo Clinic
Responsible party
Rodrigo Ruano (Regulatory Sponsor, University of Miami) — Sponsor-investigator
First posted
May 3, 2019
Start date
May 7, 2019
Primary completion
Jun 30, 2024
Completion
Jun 30, 2024
Results posted
Feb 24, 2025
Last update
Feb 24, 2025

Study contacts

Rodrigo Ruano, M.D., Ph.D.
principal investigator · University of Miami

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2025. You cannot join it, but the record below documents what was studied.

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