BTN News: It sounds like something from a sci-fi movie: babies taken from their mothers and grown in fluid-filled capsules. But scientists at the Children’s Hospital of Philadelphia (CHOP) in Pennsylvania, USA, are working on this. They want to help babies who are born too early. They are making an “artificial womb” called Extend. The goal is not to grow a baby from the start to birth. It is to help very early babies survive. These babies often have many health problems during their lives.
A normal pregnancy lasts about 40 weeks. A baby is full-term at 37 weeks. But sometimes, problems make the baby come early. Thanks to medical progress, most premature babies survive now. Even babies born at 22 weeks can live with intensive care. But babies born between 22 and 23 weeks still face big risks.
The Big Problems Premature Babies Face
Babies born very early often weigh less than 900 grams. Their organs, like the heart, lungs, stomach, and brain, are not fully developed. They need a lot of medical help to stay alive. Common short-term problems include a serious condition called necrotizing enterocolitis (NEC). This makes the intestines inflamed and damaged. These babies also easily get infections, sepsis, and septic shock. This can harm the lungs, kidneys, liver, and other organs.
Long-term problems for very early babies can include cerebral palsy, learning problems, vision and hearing issues, and asthma. Life-saving technology like oxygen and ventilators can harm their fragile lungs. This leads to conditions like bronchopulmonary dysplasia (BPD) or chronic lung disease. Children with BPD often need long-term oxygen and ventilation.
How Artificial Wombs Can Help Premature Babies
The idea behind artificial wombs and placentas is to avoid using the lungs. Life-saving technology can hurt the lungs of very early babies. At such a young age, the lungs should still be filled with fluid. When very premature babies are born, they get intubated. High-pressure air and oxygen are forced into their lungs. This causes injuries. It can lead to scarring and long-term conditions. These children may need oxygen and ventilation for life.
Artificial womb technology aims to keep the lungs out of the process. It lets the baby keep developing in a safe space until ready to breathe. Several groups are working on this. They are inspired by extracorporeal membrane oxygenation (ECMO). ECMO is a life support that helps when the lungs and heart do not work well. Blood is pumped out of the body to a machine that removes carbon dioxide and adds oxygen. Then, the blood goes back into the body. This lets the heart and lungs rest and heal.
Different Teams Working on Artificial Womb Technology
- Children’s Hospital of Philadelphia (CHOP): Alan Flake leads this team. They plan to immerse premature babies in fluid-filled capsules like the amniotic fluid in the womb. Surgeons would connect the baby’s umbilical blood vessels to an ECMO-like device. The baby’s heart pumps blood through the system naturally.
- University of Michigan: George Mychaliska’s team is making an artificial placenta. Instead of immersing the whole baby, they will fill the baby’s lungs with a special fluid using tubes. Their system drains blood from the heart through the jugular vein, like traditional ECMO. But it returns oxygenated blood through the umbilical vein. They kept premature lambs alive for 16 days before switching to a ventilator.
- Australia and Japan: This team is working on Ex Vivo Uterine Environment (Eve) therapy. They want to treat more premature and sick fetuses. Matt Kemp from the National University of Singapore leads this effort. They kept a 500-gram fetus in a normal state for two weeks.
Ethical Questions and Future Challenges
Artificial womb technology shows great promise, but it raises ethical questions. Stephanie Kukora, a neonatologist, says each technology has unique ethical challenges. For instance, some technologies need the baby transferred immediately after birth. This may need early cesarean sections, affecting future pregnancies and involving more risks than vaginal births.
Choosing which babies to use these technologies on is also hard. With no prior data except gestational age, some babies might do well with traditional therapies. But they could be given untested technologies instead.
Still, the benefits for the most premature infants are significant. Early trials will likely involve babies born before 24 weeks who have little chance of surviving with current treatments. If successful, these technologies could change neonatal care, offering new hope to parents facing premature birth.
Conclusion
Artificial wombs are a major step forward in neonatal medicine. There are many challenges ahead, both technological and ethical. But the potential to improve outcomes for extremely premature babies is huge. As research continues, these innovations could become a vital lifeline, giving hope and better lives to the tiniest and most vulnerable patients.
