nsucurrent.com April 25, 2018

New Womb-Like Device May Transform Care for Extremely Premature Infants

27 April 2017, 01:59 | Violet Powell

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Researchers are creating an artificial womb to improve care for extremely premature babies - and remarkable animal testing suggests the first-of-its-kind watery incubation so closely mimics mum that it just might work.

In pre-clinical studies with lambs, the researchers were able to mimic the womb environment and the functions of the placenta, giving premature offspring a crucial opportunity to develop their lungs and other organs. The idea is that extremely premature babies, lambs in this case, can be put into the bag which will take on the functions of a womb.

Researchers of Philadelphia recently published Nature Communications stating that the creation of a successful Biobag took multiple attempts so that it can imitate a natural womb.

But now researchers have invented an artificial womb for helping an infant lamb to grow outside its mother's womb. "These animals are, by any parameter we've measured, normal", Alan Flake, who led the study, New Scientist.

The team noted that they can now make more than 300 gallons of the artificial amniotic fluid per day, which is mostly made up of water and several different salts. The baby's heart pumps blood through the umbilical cord into the external oxygenator, which acts as the mother's placenta to exchange oxygen and carbon dioxide. The lambs' hearts circulated the blood, and there was no need for another pump. "This, in theory, could allow support of a premature infant for a period of weeks and thereby reduce, dramatically, its mortality and morbidity, and improve outcomes both short- and long-term". Doctors said the lambs, which are now one year old, "appear to have normal development in all respects". The fetal lambs breathed amniotic fluid as they normally do in the womb in a temperature-controlled, near sterile environment that is insulated from variations in temperature, pressure, light and hazardous infections.

The team kept the lamb in the artificial lung for 106 -113 days, which is the equivalent of the 23-24-week gestation premature human infant and found that the lamb were relatively healthy. After four weeks, they were put onto a regular ventilator, where researchers observed almost ideal health conditions. According to a recent estimate, every 1 in 10 babies is a preterm baby and close to 15 million babies are preterm every year. This means they are younger than 26 weeks.

Designer of the flow apparatus, Marcus Davey (also from CHOP) explains: "Fetal lungs are created to function in fluid, and we simulate that environment here, allowing the lungs and other organs to develop, while supplying nutrients and growth factors".

Modern neonatal care practices have pushed the overall survival of premature infants to 22 or 23 weeks of gestation where the infants weight a little more than 1.5 pounds and has a 30-to-50 percent chance of survival.

For human infants, that critical point comes at about 28 weeks old, when the lungs have developed enough to allow the infant to breathe air.

Working with Robert Bartlett, the inventor of the first artificial womb-like device, Mychaliska and his team have been developing their own system for a decade. And while further adaptation of the device is needed before it can begin human testing, he envisioned parents being able to see the baby and even piping in the sound of the mother's heartbeat.

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