But what if babies born prematurely could be put into an artificial womb-like environment to complete their gestation?
Ectogenesis, that is the gestation outside of a biological womb, sounds like science fiction. But one of the top stories of 2017 was the success of one group in making artificial wombs a reality—at least for lamb fetuses in later stages of their gestation.
The science is in large part motivated by the high, and steadily rising, number of babies born preterm or before 37 weeks of gestation. According to the Centers for Disease Control and Prevention, one in ten babies are born prematurely in the United States. According to the World Health Organization, that same statistic is true globally, and the United States is one of the ten countries with the highest number of preterm births (although not the highest rate). Premature births can be caused by infection, placenta problems, or genetic problems, but often the cause is not known.
Critically or extremely preterm babies, those born before 28 weeks of gestation, have survival rates that are highly dependent on income levels. In the United States, preterm births have been linked to 17% of infant deaths in recent years, while those babies that do survive have a high likelihood of major complications like cerebral palsy, breathing problems, vision problems, and developmental delays.
But what if babies born prematurely, instead of having to fight for life before they are fully equipped to do so, could be put into an artificial womb-like environment to complete their gestation?
Earlier this year, a group of scientists led by Dr. Alan Flake at the Children’s Hospital of Philadelphia were able to support the gestation of fetal lambs that were around 100 to 120 days in their gestation for up to four weeks in an artificial womb. Since lamb pregnancies are shorter than human pregnancies, these fetal lambs were developmentally equivalent to a human fetus at around 22 to 24 weeks of gestation.
What is an Artificial Womb?
The fetal lambs were placed in what the scientists call a “biobag” of regularly replenished synthetic amniotic fluid. They were connected through their umbilical cords to a life support machine outside of the bag that acted like the mother’s placenta by providing the fetus with nutrition and oxygen while also removing carbon dioxide. The artificial wombs were placed in a dark, warm room where sounds of a mother’s heart beat played.
The artificial womb environment can improve on the more standard incubator because less stress is put on the fetal heart and lungs than when pumps are used to circulate the blood and ventilators are used to force air into the lungs. The sealed environment of the artificial womb can also help keep out infections.
After leaving the artificial wombs, the lambs were observed to have normal growth, lung maturation, and brain maturation. At least one lamb was already one year old at the time the study was published.