Extreme premature infants are babies that are born before 28 weeks of gestation. Recent technological advances have ensured that these children have improved survival rates; however, babies born around 22-23 weeks of gestation typically have higher rates of chronic lung disease and other complications due to immaturity of their organs. Researchers from the Children’s Hospital of Philadelphia have now published a study in Nature Communications that describes a system that closely reproduces the environment of the womb.
The system consists of three main components: a pump-free arteriovenous circuit, a closed fluid environment with continuous fluid exchange, and a new technique of umbilical vascular access. Their closed fluid environment ensures a protective barrier between the womb and the outside world, while also helping to preserve the fluid filled lungs. In the study, the device was tested on eight lamb fetuses and demonstrated success in keeping them alive for up to four weeks outside the womb. It is notable that this is the longest and the healthiest that such early fetuses have been preserved in an extracorporeal system.
The authors recognize the ethical concerns associated with their device, and clarify in their paper that this device would only be used to improve the quality of life and survival outcomes of fetuses that are already being artificially gestated. The clinical target is expected to be 23-25 week premature infants, however, the device is still in early stages of development and will have to undergo rigorous safety testing and clinical trials including further modifications before it is available for clinical practice.
Here’s a video from the Children’s Hospital of Philadelphia with the scientists behind this research:
Study in Nature Communications: An extra-uterine system to physiologically support the extreme premature lamb…