Status:
COMPLETED
Fetal Surgery for Moderate Left Sided Congenital Diaphragmatic Hernia.
Lead Sponsor:
University Hospital, Gasthuisberg
Collaborating Sponsors:
King's College Hospital NHS Trust (UK)
Hospital Clinic of Barcelona
Conditions:
Congenital Diaphragmatic Hernia
Fetal Surgery
Eligibility:
FEMALE
18+ years
Phase:
NA
Brief Summary
Isolated Congenital Diaphragmatic Hernia (CDH) can be diagnosed in the prenatal period, and remains associated with a 30 % chance of perinatal death and morbidity mainly because of pulmonary hypoplasi...
Eligibility Criteria
Inclusion
- Patients aged 18 years or more, who are able to consent
- Singleton pregnancy
- Anatomically and chromosomally normal fetus
- Left sided diaphragmatic hernia
- Gestation at randomization prior to 31 wks plus 5 d (so that occlusion is done at the latest on 31 wks plus 6 d)
- Estimated to have moderate pulmonary hypoplasia, defined prenatally as:
- O/E LHR 25-34.9% (included; irrespective of the position of the liver)
- O/E LHR 35-44.9% (included) with intrathoracic liver herniation as determined by ultrasound or MRI
- Acceptance of randomization and the consequences for the further management during pregnancy and thereafter.
- The patients must undertake the responsibility for either remaining close to, or at the FETO center, or being able to travel swiftly and within acceptable time interval to the FETO center until the balloon is removed.
- Intended postnatal treatment center must subscribe to suggested guidelines for "standardized postnatal treatment".
- Provide written consent to participate in this RCT
Exclusion
- Maternal contraindication to fetoscopic surgery or severe medical condition in pregnancy that make fetal intervention risk full
- Technical limitations precluding fetoscopic surgery, such as severe maternal obesity, uterine fibroids or potentially others, not anticipated at the time of writing this protocol.
- Preterm labour, cervix shortened (\<15 mm at randomization) or uterine anomaly strongly predisposing to preterm labour, placenta previa
- Patient age less than 18 years
- Psychosocial ineligibility, precluding consent
- Diaphragmatic hernia: right-sided or bilateral, major anomalies, isolated left-sided outside the O/E LHR limits for the inclusion criteria
- Patient refusing randomization or to comply with return to FETO center during the time period the airways are occluded or for elective removal of the balloon
Key Trial Info
Start Date :
August 1 2010
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
March 1 2020
Estimated Enrollment :
196 Patients enrolled
Trial Details
Trial ID
NCT00763737
Start Date
August 1 2010
End Date
March 1 2020
Last Update
December 3 2020
Active Locations (13)
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1
Baylor College of Medicine/Texas Children's Hospital
Houston, Texas, United States, 77030
2
University of Texas Health Science Center
Houston, Texas, United States, 77030
3
Mater Mother's Hospital
Brisbane, Queensland, Australia, 4101
4
University Hospitals Leuven
Leuven, Belgium, 3000