'Plastic bag' womb could help keep premature babies alive

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.

Premature infants weighing as little as a pound are hooked directly to ventilators and other machines inside incubators.

The researchers created a fluid-filled transparent container to simulate how fetuses float in amniotic fluid inside mom's uterus, and attached it to a mechanical placenta that keeps blood oxygenated.

After several iterations, the team now thinks it has perfected the system and, after a few more years of animal testing, they want to try to save some human infants.

Alan Flake, fetal surgeon at the Children's Hospital of Philadelphia Research Institute, and his colleagues published their research in Nature Communications.

This artificial womb was originally created to sustain lamb fetuses - which previous research indicated are good models for human fetal development - by recreating the uterus of a pregnant animal.

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Dr Flake said there was no technology "even on the horizon" that could replace a mother's womb at the earliest stages of foetal development.

"We make gallons of this stuff a day, " said foetal physiologist Marcus Davey. They placed a probe inside the umbilical cord to provide oxygen, the way the lambs would get oxygen in utero, but left it to their hearts to move that oxygen throughout their bodies instead of using a pump as previous efforts have done. In the United States, extreme prematurity is the leading cause of infant morbidity and mortality, with over one-third of all infant deaths and one-half of cerebral palsy attributed to prematurity. When they're born too soon, doctors hook preemies to ventilators to keep them alive but risking lifelong lung damage. They've recently demonstrated a womb-like environment filled with a substance that mimics the prenatal fluid. While tests have not started on humans as of yet, Mychaliska has tested the technology on prematurely born lambs. "We supported these lambs in a very stable fashion for up to four weeks", he said. In it, you can see the premature lamb in the biobag, being artificially gestated.

The device in the fetal lamb experiment is kept in a dark, warm room where researchers can play the sounds of the mother's heart for the lamb fetus and monitor the fetus with ultrasounds. A few of the lambs have since grown to adulthood, and one is now more than a year old.

Moreover, the artificial womb is capable of supplying the optimal amount of oxygen, to ensure fetal development. "There are still huge challenges to refine the technique, to make good results more consistent and eventually to compare outcomes with current neonatal intensive care strategies", said Colin Duncan, professor of reproductive medicine and science at the University of Edinburgh, who was not involved in the research.

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. After 28 days, their lungs had matured and they were then released in normal environment so that they could breathe, which happened as expected.

Flake and his team admit more testing will need to be done before commencing with human trials.

(Copyright © 2015. All Rights Reserved.)
 
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