Artificial Placenta Offers Hope for Premature Babies

The technology was created to mimic the placenta in the womb, and has the potential to improve survival rates in the most extreme cases of premature birth.

Kristopher Sturgis

The new research comes out of the University of Michigan where several doctors from C.S. Mott Children's Hospital and the Extracorporeal Circulation Research Laboratory have created an extracorporeal artificial placenta that has kept five extremely premature lambs alive for up to two weeks. The new artificial placenta uses extracorporeal membrane oxygenation (ECMO) which enables them to recreate an intrauterine environment with no air breathing.

"Current therapy for extremely premature infants relies on mechanical ventilation and maintaining postnatal circulation," says George Mychaliska, M.D. and principal investigator on the work. "While this may be lifesaving in many instances, this approach also causes lung damage and is associated with brain bleeding. Our approach is to recreate the intrauterine environment with no air breathing, maintain fetal circulation with low fetal oxygen levels, and provide gas exchange and hemodynamic stability using extracorporeal support."

The technology uses tubes that are placed in the umbilical vein as the inflow, and tubes placed in the jugular vein as the outflow. This creates a circuit for the blood to circulate through as an oxygenator. Mychaliska says that recreating this kind of intrauterine environment not only helps maintain fetal circulation, but is also remarkably stable without any air breathing.

"We believe this approach is revolutionary and will lead to a new paradigm to treat extremely premature infants," he says. "The mortality rate of extremely low gestational age newborns--which are defined as newborns with less than 28 weeks of estimated gestational age--is extremely high. The survival rate of a 24 week infant is approximately 50%, and it is important to note that many infants that do survive have significant long term health problems. This artificial placenta holds promise not only to improve survival, but also ameliorate the long term health problems associated with extreme prematurity."

Advancements in medical device technologies and 3-D printing have enabled researchers around the world to create new innovative organ replacements that are designed to match their organic counterparts with unprecedented precision. Earlier this year researchers from Harvard brought us one step closer to 4-D printing techniques that could pave the way for new medical devices and replacement organs that mimic human organs unlike ever before.

In time, Mychaliska and his colleagues hope to deliver an artificial placenta that can look and feel every bit as real as the intrauterine environment that fosters normal newborn development. Over the next five years, the group hopes to demonstrate that the artificial placenta can effectively simulate the intrauterine environment and support a newborn fetal lamb all the way from extreme prematurity to normal newborn physiology.

"We are very excited by our recent findings suggesting ongoing lung and brain development and protection," Mychaliska says. "We have supported extremely premature lambs for up to two weeks now, and we are working on transitioning them to mechanical ventilation and then air breathing. Using human clinical data, we are refining our ability to prognosticate mortality in the first day of life in an extremely premature infant. These infants that are at high risk for mortality would be the first candidates in a clinical trial. Given the pace of our research effort, we believe clinical translation is possible in five years time." 

Kristopher Sturgis is a contributor to Qmed.

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