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Artificial Womb Breakthrough: Navigating the Moral Dilemma for Premature Babies

BTN News: Premature birth is a global challenge, with millions of infants born too soon every year, facing severe health complications. But a groundbreaking innovation might soon change that. Scientists from the Children’s Hospital of Philadelphia (CHOP), the University of Michigan, and a joint team from Australia and Japan are racing to develop artificial wombs to improve survival rates and quality of life for extremely premature babies.

These new technologies, inspired by the body’s natural environment, aim to provide a safer alternative for babies born as early as 22 to 23 weeks, who currently face high risks of mortality and long-term health issues. Here’s how these advancements could transform neonatal care.

The Problem: High Risks for Extremely Premature Infants

Premature infants born at 22 to 23 weeks weigh less than 900 grams and have organs that are not fully developed, making them extremely vulnerable. Their lungs, hearts, and digestive systems are too immature to function properly outside the womb. Even the best medical interventions, such as ventilation and oxygen therapy, can cause further damage to their fragile bodies.

These infants are at risk of developing serious complications like enterocolitis, sepsis, and bronchopulmonary dysplasia — a chronic lung condition caused by the high pressure and oxygen used in conventional treatments. For many of these infants, survival comes at the cost of long-term health issues like cerebral palsy, vision and hearing problems, and developmental delays.

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Innovative Solution: Artificial Wombs to Mimic Natural Development

To address these challenges, scientists are developing artificial wombs that replicate the environment of a mother’s womb. These innovations aim to extend the development of premature infants in a controlled, safe environment until they are mature enough to breathe on their own.

1. CHOP’s “Extend” Artificial Womb System

At the forefront of this research is the team led by Dr. Alan Flake at the Children’s Hospital of Philadelphia. Their system, known as “Extend,” involves placing premature infants in a liquid-filled capsule designed to mimic the amniotic fluid environment. Here, the baby’s blood is oxygenated through a device similar to extracorporeal membrane oxygenation (ECMO), with the baby’s own heart pumping blood, just as it would in utero.

In 2017, the team successfully kept eight premature lambs alive and developing for four weeks using this system, a promising step towards human trials. They are now seeking approval from the U.S. Food and Drug Administration (FDA) to begin clinical trials.

2. University of Michigan’s Artificial Placenta

Meanwhile, researchers at the University of Michigan are creating an artificial placenta. Unlike CHOP’s liquid-filled capsule, this system fills the infant’s lungs with a specially developed liquid, reducing the need for invasive ventilation. The blood is circulated from the heart via the jugular vein, similar to traditional ECMO, but returned through the umbilical vein, allowing for more gradual adaptation and reducing lung damage risks.

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Premature lambs kept in this device have survived for up to 16 days with continued organ development. The team plans to move to human trials within the next few years.

3. Eve: A Collaborative Effort by Australia and Japan

A third team, combining expertise from Australia and Japan, is developing “Eve,” a therapy that allows fetuses to remain in a near-natural uterine environment outside the mother. Their system has successfully kept a 500-gram lamb fetus in a “normal physiological state” for two weeks, a remarkable achievement, though challenges remain in replicating normal growth rates for all premature infants.

Ethical Considerations: Weighing Benefits Against Risks

As these technologies edge closer to human trials, ethical concerns emerge. Critics, including neonatologist Stephanie Kukora, argue that the use of artificial wombs brings unique challenges, particularly in consent and the immediate transfer of infants to these devices. For instance, babies need to be connected quickly to the system, often requiring a cesarean section for immediate intervention — a procedure that carries its own risks for the mother.

Additionally, there is uncertainty in identifying which infants would benefit most from such technology. Without established criteria for patient selection, there is a risk of applying these methods to babies who might do well with conventional care, thus exposing them to unknown dangers.

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A Step Towards Human Trials: What Lies Ahead?

Despite the challenges, researchers remain optimistic. The Children’s Hospital of Philadelphia could soon begin the first human trials, while the University of Michigan aims to follow within three to four years. However, the Australian and Japanese teams emphasize that much remains to be understood about the intricacies of fetal growth in artificial environments.

Neonatologist George Mychaliska believes that artificial womb technology will revolutionize care for the most vulnerable infants. He envisions a future where these devices could significantly improve outcomes for babies born as early as 22 weeks. Yet, he cautions that these innovations must be introduced carefully, starting with those who have the least chance of survival with current treatments.

Conclusion: A Future of Hope and Innovation for Preterm Infants

If successful, these artificial womb technologies could offer a groundbreaking new approach to neonatal care, reducing mortality and long-term complications for the most premature infants. While ethical concerns and technical challenges remain, the potential to provide a lifeline for thousands of families is a powerful motivator driving these efforts forward.

As researchers continue to refine their methods and prepare for human trials, the world watches in anticipation, hoping for a future where extreme prematurity no longer means a life defined by limitations.

Bright Times News Desk
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