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Congenital Diaphragmatic HerniaNCT07166172

Prospective Registry for Long-term Outcomes Following FETO in Severe Left and Right CDH

A study testing Fetal Treatment Arm (FETO Group) in people with Congenital Diaphragmatic Hernia and Congenital Abnormalities, run by Johns Hopkins University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This registry study aims to confirm that FETO increases neonatal survival to discharge and reduces long-term morbidity in fetuses with isolated left CDH and o/e LHR < 30%, or isolated right CDH and o/e LHR ≤ 45%, compared to those receiving standard care. Read more about this study

Who is it for?
Ages 18 years and older, women only
What is being tested?
Fetal Treatment Arm (FETO Group)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteUnited States
Study dates
23 Jun 2025to 1 Dec 2031
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pregnant women age 18 years and older
  • Singleton pregnancy
  • Normal Karyotype, chromosomal microanalysis (CMA) with non-pathologic variants, whole exome sequencing (WES) or whole genome sequencing (WGS). Results by fluorescence in situ hybridization (FISH) will be acceptable if the patient is > 26 weeks gestation.
  • Gestational age at enrollment is prior to 29 weeks + 6 days gestation.
  • Intrathoracic liver herniation:
  • Isolated left CDH with o/e LHR < 30% at enrollment (18wks + 0 days to 29wks + 5 days gestation).
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  • Isolated right CDH with o/e LHR ≤ 45% at enrollment (18wks + 0 days to 29wks + 5 days gestation).
  • Cervical length by transvaginal ultrasound ≥ 20 mm within 24 hours prior to FETO procedure.
  • Patient meets psychosocial criteria.
  • Informed consent understood.

Who cannot join

  • Patient < 18 years of age
  • Multi-fetal pregnancy
  • History of natural rubber latex allergy
  • Preterm labor, cervix shortened (<20 mm at enrollment or within 24 hours of FETO balloon insertion procedure) or uterine anomaly strongly predisposing to preterm labor, placenta previa.
  • Psychosocial ineligibility, precluding consent:
  • Inability to reside within 30 minutes of Johns Hopkins Hospital Center for Fetal Therapy.
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  • The patient does not have a support person (e.g., spouse, partner, mother) available to stay with the patient for the duration of the pregnancy at Johns Hopkins Hospital Center for Fetal Therapy.
  • Bilateral CDH, isolated left sided CDH with O/E LHR ≥ 30% (18wks + 0 days to 29wks + 5 days gestation), isolated right sided CDH with O/E LHR > 45% (18wks + 0 days to 29wks + 5 days gestation), as determined by ultrasound.
  • No liver herniation into thoracic cavity.
  • Additional fetal anomaly and chromosomal abnormalities by ultrasound, MRI, or echocardiogram at the fetal treatment center. Exclude chromosomal abnormalities, associated anomalies recognized to alter survival prognosis (i.e., CDH and congenital heart disease) or presence of an underlying genetic syndrome (i.e., Fryns).
  • Maternal contraindication to fetoscopic surgery or severe maternal medical condition in pregnancy.
  • History of incompetent cervix with or without cerclage.
  • Placental abnormalities (previa, abruption, accreta) known at time of enrollment
  • Maternal-fetal Rh isoimmunization, Kell sensitization or neonatal alloimmune thrombocytopenia affecting the current pregnancy.
  • Maternal HIV, Hepatitis-B, Hepatitis-C status positive because of the increased risk of transmission to the fetus during maternal-fetal surgery. If the patient's HIV or Hepatitis status is unknown, the patient must be tested and found to have negative results before enrollment.
  • Uterine anomalies such as large or multiple fibroids or Mullerian duct abnormality.
  • There is no safe or technically feasible fetoscopic approach to balloon placement.
  • Participation in another intervention study that influences maternal and fetal morbidity and mortality. or participation in this trial in a previous pregnancy.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Ahmet Baschat, MD contact

410-502-6561

abascha1@jhmi.edu

United States1 site, 1 recruiting
  • Johns Hopkins Hospital

    Baltimore, Maryland, 21287

    Ahmet A. Baschat, MD, 410-502-6561, abascha1@jhmi.edu

    Recruiting

Other trials in United States

About this study

Official title: North American Fetal Therapy Network Prospective Registry for Long-term Outcome Following Fetoscopic Endoluminal Tracheal Occlusion in Severe Left and Right Congenital Diaphragmatic Hernia

This registry study aims to confirm that FETO increases neonatal survival to discharge and reduces long-term morbidity in fetuses with isolated left CDH and o/e LHR < 30%, or isolated right CDH and o/e LHR ≤ 45%, compared to those receiving standard care. This prospective registry plans to enroll 80 pregnant women (40 treatment/40 control) with fetuses diagnosed with isolated CDH, and the children will be followed for up to 24 months.

Read the detailed description

The purpose of this study is to evaluate successful placement and removal of Fetoscopic Endoluminal Tracheal Occlusion (FETO) device in cases of intrathoracic liver herniation with isolated left congenital diaphragmatic hernia (LCDH) with Observed/Expected (O/E) Lung to Head Circumference Ratio (LHR) < 30% or isolated right congenital diaphragmatic hernia (RCDH) with O/E LHR ≤ 45%,to compare survival to discharge from the neonatal intensive care units (NICU), between fetuses with intrathoracic liver herniation and isolated LCDH with O/E LHR < 30% that receive FETO procedure performed at 27 weeks + 0 days to 29weeks + 6 days of gestation to those with intrathoracic liver herniation, isolated LCDH and o/e LRH < 30% that undergo expectant management, to compare the neonatal survival rate to discharge from the neonatal intensive care units (NICU), between fetuses with intrathoracic liver herniation, isolated RCHD with o/e LHR ≤ 45% that undergo FETO procedure performed at 27 weeks + 0 days to 29 weeks + 6 days gestation to those with intrathoracic liver herniation, isolated RCHD and o/e LHR ≤ 45% that elect to proceed with expectant management, to evaluate the frequency of maternal and fetal complications associated with FETO procedure, to evaluate whether the FETO procedure is associated with reduced long-term mortality and morbidities in isolated LCDH survivors with o/e LHR <30% when compared to isolated LCDH with o/e LRH <30% that undergo expectant management where all fetuses were found to have intrathoracic liver herniation and to evaluate whether the FETO procedure is associated with reduced long-term mortality and morbidities in isolated RCDH survivors with o/e LHR ≤ 45% when compared to isolated RCHD with LHR ≤ 45% that undergo expectant management where all fetuses were found to have intrathoracic liver herniation.

Being tested
Fetal Treatment Arm (FETO Group)
Keywords
Fetoscopic Endoluminal Tracheal Occlusion
Medical subject headings
Hernias, Diaphragmatic, Congenital, Congenital Abnormalities, Congenital, Hereditary, and Neonatal Diseases and Abnormalities, Hernia, Diaphragmatic, Internal Hernia, Hernia, Pathological Conditions, Anatomical, Pathological Conditions, Signs and Symptoms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Fetal Treatment Arm (FETO Group)Device

    Also called Fetal Endoluminal Tracheal Occlusion (FETO)

    Participants will undergo FETO surgery between 27 weeks + 0 days to 29 weeks + 6 days gestation. The FETO intervention involves two procedures: (1) inserting a balloon into the fetal trachea, and (2) removing the balloon before delivery. After the first FETO procedure, participants will be monitored weekly by ultrasound. Removal of the balloon will be performed at 34 weeks + 0 days to 34 weeks + 6 days gestation. Planned delivery will occur after 37 weeks. The follow-up phase will be conducted from birth to 24 months of age.

Study groups in NCT07166172
Study groupRoleWhat they receive
Fetal Treatment Arm (FETO Group)ExperimentalNot described
Receives: Device: Fetal Treatment Arm (FETO Group)
Expectant Management Arm (Control Group)No interventionStandard of care treatment for babies with congenital diaphragmatic hernia.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of successful placement of FETO device

    Measured: 10-60 minutes after surgery begins

  2. Number of successful removal of FETO device

    Measured: Immediately after the procedure (about 1 hour after start of surgery)

  3. Number of FETO procedure complications

    Complications include: Failure FETO insertion procedure, FETO device dislodgement potentially requiring a second FETO insertion, Fetal intraoperative injury, Procedural hemorrhage, Bleeding from insertion site or Abruptions, Post-procedural hemorrhage PPROM, Preterm delivery, Chorioamnion separation, Chorioamnionitis, Polyhydramnios, Oligohydramnios, Emergent removal due to obstetrical complication, Failed percutaneous or fetoscopic removal requiring cesarean section or exit procedure for removal, Neonatal death due to asphyxia if delivery before FETO removal, and Non-reassuring fetal heart rate monitoring.

    Measured: End of study (24 months)

  4. Number of neonates that survived

    Neonatal survival to discharge

    Measured: From delivery to hospital discharge

Secondary outcomes (48)
  1. Number of infants that survived

    Measured: 6 months

  2. Number of infants that survived

    Measured: 12 months

  3. Number of infants that survived

    Measured: 18 months

  4. Number of infants that survived

    Measured: 24 months

  5. Number of infants that show presence of pulmonary hypertension

    Measured: 6 months

  6. Number of infants that show presence of pulmonary hypertension

    Measured: 12 months

  7. Number of infants that show presence of pulmonary hypertension

    Measured: 18 months

  8. Number of infants that show presence of pulmonary hypertension

    Measured: 24 months

  9. Number of infants that show need for supplemental oxygen

    Measured: 6 months

  10. Number of infants that show need for supplemental oxygen

    Measured: 12 months

  11. Number of infants that show need for supplemental oxygen

    Measured: 18 months

  12. Number of infants that show need for supplemental oxygen

    Measured: 24 months

  13. Number of infants that show periventricular leukomalacia

    Measured: At less than 2 months postnatally

  14. Number of Infants that develop sepsis

    Measured: 6 months

  15. Number of Infants that develop sepsis

    Measured: 12 months

  16. Number of Infants that develop sepsis

    Measured: 18 months

  17. Number of Infants that develop sepsis

    Measured: 24 months

  18. Number of infants that develop Intraventricular hemorrhage (grade 0-III)

    Measured: 6 months

  19. Number of infants that develop Intraventricular hemorrhage (grade 0-III)

    Measured: 12 months

  20. Number of infants that develop Intraventricular hemorrhage (grade 0-III)

    Measured: 18 months

  21. Number of infants that develop Intraventricular hemorrhage (grade 0-III)

    Measured: 24 months

  22. Number of infants that develop retinopathy of prematurity (grade 3 or higher)

    Measured: 6 months

  23. Number of infants that develop retinopathy of prematurity (grade 3 or higher)

    Measured: 12 months

  24. Number of infants that develop retinopathy of prematurity (grade 3 or higher)

    Measured: 18 months

  25. Number of infants that develop retinopathy of prematurity (grade 3 or higher)

    Measured: 24 months

  26. Number of infants that develop gastro-esophageal reflux

    Measured: 6 months

  27. Number of infants that develop gastro-esophageal reflux

    Measured: 12 months

  28. Number of infants that develop gastro-esophageal reflux

    Measured: 18 months

  29. Number of infants that develop gastro-esophageal reflux

    Measured: 24 months

  30. Number of infant hospital readmissions

    Measured: End of study (24 months)

  31. Cause of infant hospital readmissions

    Measured: End of study (24 months)

  32. Number of infants that show childhood growth failure

    Measured: 6 months

  33. Number of infants that show childhood growth failure

    Measured: 12 months

  34. Number of infants that show childhood growth failure

    Measured: 18 months

  35. Number of infants that show childhood growth failure

    Measured: 24 months

  36. Number of infants that show recurrence of CDH repair

    Measured: 6 months

  37. Number of infants that show recurrence of CDH repair

    Measured: 12 months

  38. Number of infants that show recurrence of CDH repair

    Measured: 18 months

  39. Number of infants that show recurrence of CDH repair

    Measured: 24 months

  40. Number of infants that develop bowel obstruction

    Measured: 6 months

  41. Number of infants that develop bowel obstruction

    Measured: 12 months

  42. Number of infants that develop bowel obstruction

    Measured: 18 months

  43. Number of infants that develop bowel obstruction

    Measured: 24 months

  44. Number of infants that show neurodevelopmental delay as assessed by the Bayley Scales of Infant and Toddler Development-III(BSID)

    Three domains will be measured as follows: Cognitive Scale, Language Scale (Receptive and Expressive) and Motor Scale (Fine and Gross Motor Skills). Scores are derived by converting raw scores from completed tasks into scale scores and composite scores. These scores are then utilized to assess the child's performance in relation to norms established based on typically developing children of the same age

    Mean score of 100 (SD=15) at the 50th percentile signifies mid-average functioning.

    Scores below 85 (1 SD below the mean), at the 16th percentile, indicate mild impairment of being 'at risk' of developmental delay.

    Score below 70 (2 SD below the mean), at the second percentile, indicate moderate to severe impairment.

    In general, scores falling in the lowest 10th percentile indicate developmental delay

    Measured: 24 months

  45. Number of infants that develop bronchopulmonary dysplasia

    Measured: 6 months

  46. Number of infants that develop bronchopulmonary dysplasia

    Measured: 12 months

  47. Number of infants that develop bronchopulmonary dysplasia

    Measured: 18 months

  48. Number of infants that develop bronchopulmonary dysplasia

    Measured: 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Sep 2025
  2. Study start23 Jun 2025
  3. Primary completion1 Dec 2029 (estimated)
  4. Study completion1 Dec 2031 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07166172
Sponsor's protocol ID
IRB00495298
Status last verified
Apr 2026
First submitted
3 Sep 2025
Last updated
23 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Fetal Treatment Arm (FETO Group) in people with Congenital Diaphragmatic Hernia and Congenital Abnormalities, run by Johns Hopkins University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 23 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Ahmet Baschat, MD (410-502-6561, abascha1@jhmi.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of successful placement of FETO device (time frame: 10-60 minutes after surgery begins). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Apr 2026.

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