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Researchers have successfully tested a groundbreaking artificial womb on a lamb foetus, and they make the bold claim the technique could be used to care for premature human babies as early as 2027.
The bizarre 'biobag' device mimics the prenatal fluid-filled organ to give premature infants vital extra weeks to develop their lungs and other bodily functions. It is hoped the innovative system could eventually be used to support babies between the 23-week and 28-week gestational stage, and improve survival rates for those born prematurely. Premature birth is currently the biggest global killer of young children.
"Our system could prevent the severe morbidity suffered by extremely premature infants by potentially offering a medical technology that does not currently exist," said study leader Alan Flake, from the Center for Fetal Diagnosis and Treatment at Children's Hospital of Philadelphia (Chpop).
Some 60,000 babies are born prematurely in the UK every year, according to pregnancy charity Tommy's. Those born at 23 weeks have a survival rate of just 15 per cent, but that goes up to 55 per cent at 24 weeks and 80 per cent at 25 weeks.
"These infants have an urgent need for a bridge between the mother's womb and the outside world," said Flake. "If we can develop an extra-uterine system to support growth and organ maturation for only a few weeks, we can dramatically improve outcomes for extremely premature babies."
In the study, the fluid-filled 'bag' was attached to custom-designed machines providing physiological support in a temperature-controlled, near-sterile environment. The foetal lambs were able to breathe amniotic fluid as they normally would in the womb, with their hearts pumping blood through an umbilical cord into a gas exchange machine outside the bag.
Designed to mimic a uterus as closely as possible, the system has no external pump to drive circulation, because even gentle artificial pressure can fatally overload an underdeveloped heart. Likewise, there is no ventilator because immature lungs are not yet developed enough to breathe atmospheric oxygen.
Electronic monitors were used to measure vital signs as well as blood flow and other vital functions of the lambs.
"Foetal lungs are designed to function in fluid, and we simulate that environment here, allowing the lungs and other organs to develop, while supplying nutrients and growth factors," said foetal physiologist Marcus Davey who designed the psuedo-womb's inflow and outflow system.
The researchers have developed several prototypes of the artificial womb over the past three years, starting off with a glass incubator tank and resulting in the current fluid-filled sac.
Eight lambs, equivalent to a 23- or 24-week humans were tested using the current system.
The team plans to continue developing and testing the system and will eventually need to downsize it for humans, which are around one third the size of the lambs used in the study.
Assuming that further testing proves the technology can be used for premature human babies, the researchers believe that the technology could be in use in ten years' time.
The researchers stress the system cannot be used for extremely premature babies born before 23 weeks as the the physical size and physiology of the foetus would present unacceptably high risks.
Speaking about the likelihood of transferring the tech to humans within ten years, Neena Modi, a professor of neonatal medicine at Imperial College London, told WIRED: "I very much doubt this; a very considerable amount of pre-clinical, followed by painstaking, cautious clinical safety testing would be required before proceeding with more wide scale clinical testing.
"A considerable amount of research is always needed to ensure human safety. It cannot be assumed that what is safe and effective in one species will necessarily be so in another.
"This research, even if ultimately successful, does not address the primary goal of newborn medicine, which is to prevent preterm birth. A substantial proportion of preterm birth has origins in socio-economic disadvantage and poor maternal health, issues that require widescale societal change," she added.
The study is published in the journal Nature Communications.
This article was originally published by WIRED UK
