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Active, not recruitingNCT04362592Updated May 4, 2026

In-Utero Endoscopic Correction of Spina Bifida

An interventional study of In Utero Endoscopic Correction of Myelomeningocele IDE - Percutaneous Technique and In Utero Endoscopic Correction of Myelomeningocele IDE - Laparotomy/Uterine Exteriorization Technique in Neural Tube Defects, Spina Bifida and Myelomeningocele, sponsored by University of Southern California. Active, not recruiting at 2 sites in United States. Open to female participants aged 18 Years to 52 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-05-04.

Sponsored by University of Southern California · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 1 year 4 months after the study started (first participant enrolled Nov 2018, registered Mar 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
110
Allocation
Non-randomized
Ages
18 Years to 52 Years
Sex
Female
01

Study summary

The purpose of this study is to evaluate the feasibility and effectiveness of performing fetoscopic surgical correction of fetal spina bifida. Two surgical approaches will be utilized: the percutaneous technique versus the laparotomy/uterine exteriorization technique.

02

Conditions studied

  • Neural Tube Defects
  • Spina Bifida
  • Myelomeningocele
03

In context

Neural Tube Defects

47 studies on the registry are indexed under Neural Tube Defects; 9 are open to participants now.

This study's planned enrollment of 110 is above the median of 47 across 26 interventional studies indexed under Neural Tube Defects.

Browse Neural Tube Defects studies →

Lead sponsor

University of Southern California is the lead sponsor of 791 studies on the registry; 136 are open to participants now.

Of its 70 completed or terminated interventional studies of FDA-regulated products, 32 (46%) have results posted.

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

04

Who can participate

Ages eligible
18 Years to 52 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Myelomeningocele (including myeloschisis) at level T1 through S1 with hindbrain herniation. Lesion level and hindbrain herniation will be confirmed by MRI and ultrasonography.
  2. Maternal age ≥18 years.
  3. Gestational age of 19 to 27 6/7 weeks' gestation as determined by clinical information and evaluation of first ultrasound.
  4. Balanced karyotype and/or normal mircoarray 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.
  5. Positive evaluation of social work consult indicating the patient is capable of consenting to the procedure and has the appropriate social support system to participate in the study.
  6. Positive evaluation from pediatric neurology consult.
  7. Willing to return to our center, or to a multi-disciplinary spina bifida clinic closer to their home for the 6, 12, 24, 30, 48, and 60 months follow-up evaluations.

Exclusion criteria

Exclusion Criteria:

  1. Multiple gestation
  2. Insulin-dependent pregestational diabetes
  3. Presence of a fetal anomaly not related to Chiari II Malformation. A fetal echocardiogram will be conducted before surgery and if the finding is abnormal, the patient will be excluded.
  4. Fetal kyphosis of 30 degrees or more, assessed by ultrasound or MRI.
  5. Presence of uterine cervical cerclage or history of incompetent cervix.
  6. Placenta previa or placental abruption.
  7. Short cervix \< 25 mm measured by cervical ultrasound.
  8. Obesity as defined by (BMI) of 40 or greater.
  9. History of previous spontaneous singleton delivery prior to 37 weeks.
  10. Maternal-fetal Rh isoimmunization, Kell sensitization or a history of neonatal alloimmune thrombocytopenia.
  11. Maternal or Hepatitis-B status positive because of the increased risk of transmission to the fetus during maternal-fetal surgery. If the patient's HIV or status is unknown, the patient must be tested and found to have negative results before she can be enrolled.
  12. Known Hepatitis-C positivity. If the patient's status is unknown, she does not need to be screened.
  13. Uterine anomaly such as large (greater than 6 cm) fibroids, cervical fibroids or multiple fibroids or Mullerian duct abnormality.
  14. Other maternal medical condition which is a to surgery or anesthesia.
  15. Patient does not have a support person (e.g., husband, partner, parents).
  16. Inability to comply with the travel and follow-up requirements of the study.
  17. Patient does not meet psychosocial criteria as determined by the social worker evaluation.
  18. Participation in another intervention study that influences maternal and fetal morbidity and mortality.
  19. Maternal hypertension as determined by the investigator, which would increase the risk of preeclampsia or preterm delivery (including, but not limited to: uncontrolled hypertension, chronic hypertension with end organ damage and new onset hypertension in current pregnancy).
  20. Bicornuate uterus or any other uterine malformation the PI decides is not safe for surgery.
  21. Nickel allergy.
  22. Maternal request to undergo open fetal surgery for the antenatal correction of OSB at our institution primarily or after failed fetoscopic approach.
  23. Known maternal to bovine collagen or chondroitin materials.
Terms in these criteria, in plain language(6)

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.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

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.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

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.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
110 participants (estimated)

Study arms

  • Experimental
    Percutaneous Technique

    The percutaneous technique uses endoscopic scopes through the maternal skin and uterus to perform the surgery. A variation of the percutaneous technique is the mini-laparotomy technique, which uses an endoscopic scope through an incision on the abdomen, smaller than a laparotomy ("mini-laparotomy"), and smaller endoscopic scopes through the maternal skin and uterus to perform the surgery.

    Device: In Utero Endoscopic Correction of Myelomeningocele IDE - Percutaneous Technique

  • Experimental
    Laparotomy/Uterine Exteriorization Technique

    The laparotomy/uterine exteriorization technique consists of performing a laparotomy (incision into the abdominal cavity), exteriorizing the uterus, and using endoscopic scopes through the uterus to perform the correction.

    Device: In Utero Endoscopic Correction of Myelomeningocele IDE - Laparotomy/Uterine Exteriorization Technique

Interventions

  • DeviceIn Utero Endoscopic Correction of Myelomeningocele IDE - Percutaneous Technique

    The percutaneous approach uses endoscopes through a closed maternal abdomen and closed uterus to perform the spina bifida correction.

  • DeviceIn Utero Endoscopic Correction of Myelomeningocele IDE - Laparotomy/Uterine Exteriorization Technique

    The laparotomy/uterine exteriorization technique uses endoscopes through an open abdomen and closed, exteriorized uterus to perform the spina bifida correction.

06

What researchers measure

Primary outcomes

  1. Ability to perform the endoscopic procedure

    Successful fetoscopic closure of the defect

    Time frame: At time of surgery

Secondary outcomes

  1. Chiari II malformation reversal

    Reversal of hindbrain herniation on ultrasound and MRI

    Time frame: Prior to delivery

07

Study locations

2 sites
  • Hollywood Presbyterian Medical Center
    Los Angeles, California 90027, United States
  • Wellington Regional Medical Center
    Wellington, Florida 33141, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04362592
Collaborators
USFetus
Responsible party
Ramen Chmait (Professor, University of Southern California) — Principal investigator
First posted
Apr 27, 2020
Start date
Nov 2, 2018
Primary completion
Jun 29, 2025
Completion
Dec 31, 2031 (estimated)
Last update
May 4, 2026

Study contacts

Ruben Quintero, MD
principal investigator · US Fetus
Ramen Chmait, MD
principal investigator · University of Southern California

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 active, not recruiting, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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