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Prenatal Steroids for Treatment of Congenital Cystic Adenomatoid Malformations (CCAM) (CCAM Steroids)

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ClinicalTrials.gov Identifier: NCT00670956
Recruitment Status : Terminated (Recruitment has been poor. Study drug is being offered as part of standard care of women carrying a pregnancy diagnosed with CCAM)
First Posted : May 2, 2008
Results First Posted : March 30, 2015
Last Update Posted : March 30, 2015
Children's Hospital Medical Center, Cincinnati
Children's Hospital of Philadelphia
Information provided by (Responsible Party):
University of California, San Francisco

Brief Summary:
Congenital cystic adenomatoid malformations (CCAMs) are theorized to be growing immature lung tissue. Administration of maternal steroids in the mid-trimester may stop the growth or decrease the size of the CCAM, thus increasing normal lung tissue and improving survival in fetuses with large CCAMs. This is a prospective, blinded, randomized trial comparing administration of a single course of antenatal steroids (Betamethasone) to control (i.e., placebo). The primary outcome variable will be incidence of hydrops. One month postnatal survival and relative size of the CCAM as determined by CCAM volume:head circumference ratio (CVR) between treatment/no treatment groups will be secondary outcome variables. Change in size of CCAM will be serially followed for both groups with individual growth curves being plotted prenatally and these will be compared with pathology weigh and volume to evaluate treatment effect. Other prenatal data collected will include: incidence of polyhydramnios, incidence of premature rupture of membranes, incidence of material complications. We will also compare mode of delivery, postnatal respiratory compromise, need for resection in the first week of life, and occurrence of complications during newborn administration

Condition or disease Intervention/treatment Phase
Congenital Cystic Adenomatoid Malformation Drug: Betamethasone Drug: Placebo Phase 1 Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Investigation of Prenatal Steroids for Treatment of Prenatally Diagnosed CCAMs
Study Start Date : April 2008
Actual Primary Completion Date : September 2011
Actual Study Completion Date : September 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Active Study Group
STEROID: Betamethasone; 12 mg intramuscularly x 2 doses 24 hours apart
Drug: Betamethasone
12 mg intramuscularly x 2 doses 24 hours apart

Placebo Comparator: Placebo Group
PLACEBO: IM x 2 doses 24 hours apart
Drug: Placebo
PLACEBO: IM x 2 doses 24 hours apart

Primary Outcome Measures :
  1. Incidence of Hydrops Fetalis [ Time Frame: Delivery, up to approximately 20 weeks post-enrollment ]

Secondary Outcome Measures :
  1. Comparison of CCAM Size in Mid-trimester Fetuses (Study/Administration vs Control/Placebo) [ Time Frame: Baseline, Delivery (up to approximately 20 weeks post-enrollment) ]
  2. Survival at One-month Between Study and Control Groups. [ Time Frame: 30 days after delivery (up to approximately 24 weeks post-enrollment) ]
    Status of neonate survival 30 days after delivery

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • GA < 26 weeks
  • Maternal age > 18 years of age
  • Singleton pregnancy
  • Normal chromosomes
  • CCAM volume to head circumference ratio (CVR) > 1.4
  • No maternal medical/surgical contraindications
  • No evidence of hydrops
  • Not previously randomization

Exclusion Criteria:

  • Maternal diabetes or use of insulin
  • Preterm labor
  • Multiple congenital anomalies with CCAM
  • Chromosomal anomaly with CCAM
  • Multiple gestation pregnancy with CCAM
  • Not willing to be randomized
  • Unable or unwilling to return to UCSF for second dose of drug or placebo
  • CVR < 1.4

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00670956

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United States, California
University of California, San Francisco Fetal Treatment Center
San Francisco, California, United States, 94143
United States, Ohio
Cincinnati Children's Hospital
Cincinnati, Ohio, United States, 45229-3039
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of California, San Francisco
Children's Hospital Medical Center, Cincinnati
Children's Hospital of Philadelphia
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Principal Investigator: Timothy M Crombleholme, MD Children's Hospital of Cincinnati
Principal Investigator: Douglas Wilson, MD Children's Hospital of Philadelphia
Principal Investigator: Hanmin Lee, MD University of California, San Francisco
Additional Information:

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Responsible Party: University of California, San Francisco
ClinicalTrials.gov Identifier: NCT00670956    
Other Study ID Numbers: 10-03705
First Posted: May 2, 2008    Key Record Dates
Results First Posted: March 30, 2015
Last Update Posted: March 30, 2015
Last Verified: March 2015
Keywords provided by University of California, San Francisco:
prenatal steroids
congenital cystic adenomatoid malformation of the lung
prenatal intervention
prenatal diagnosis
Additional relevant MeSH terms:
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Cystic Adenomatoid Malformation of Lung, Congenital
Congenital Abnormalities
Lung Diseases
Respiratory Tract Diseases
Respiratory System Abnormalities
Anti-Inflammatory Agents
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents