Published: Fri, April 28, 2017
Health Care | By Jan Bell

'Biobag' system mimics womb, could provide hope for premature babies

Just as the fetus is surrounded by the amniotic liquid inside the mom's uterus, the plastic bag-like womb is filled with a liquid which has the same physiological properties as its biological counterpart.

"We've developed a system that, as closely as possible, reproduces the environment of the womb and replaces the function of the placenta", said Dr. Alan Flake, a fetal surgeon and director of the Center for Fetal Research in the Center for Fetal Diagnosis and Treatment at Children's Hospital of Philadelphia (CHOP) who led the research, published Tuesday.

The team tested its extra-uterine device on eight preterm lambs which were physiologically equivalent to a 23- or 24-week-gestation human infant.

Initially, this test has been done on prematurely born lambs and they have successfully grown in these artificial wombs.

The researchers created a fluid-filled transparent container to simulate how fetuses float in amniotic fluid inside mom's uterus, and attached it to a mechanical placenta that keeps blood oxygenated.

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Designer of the flow apparatus, Marcus Davey (also from CHOP) explains: "Fetal lungs are created to function in fluid, and we simulate that environment here, allowing the lungs and other organs to develop, while supplying nutrients and growth factors".

While inside the bags, the lambs opened their eyes, had normal breathing and swallowing movements and grew wool. The big question was: Would the lamb fetus survive?

At present, doctors use incubators and ventilators to help babies stay alive and breathe but this can cause damage to the development of their lungs.

Children's Hospital researchers plan to do one more animal study, and to upgrade the Biobag with medical-grade plastics. It helped out severely premature born animals to develop normally for a month.

Flake said that such ethical concerns need to be balanced with the risks premature babies face, such as severe disabilities and even death.

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"So many research groups have been trying to develop a system like this since the 1950s, however they've met with limited success", Dr Davey said. But while that future is still far, far away, some arresting progress has been made with an artificial womb that's giving birth to lambs.

Lambs were used due to their close genetic proximity to humans. But even if extremely premature babies survive, they're often left with permanent health problems as a result of their early emergence.

The challenge is now to develop a version of the technology for human babies, which the team believes can be done in three to five years. "This could establish a new standard of care for this subset of extremely premature infants", Flake said in a statement.

"This will require a lot of additional preclinical research and development and this treatment will not enter the clinic any time soon", Colin Duncan of the University of Edinburgh, Scotland, who was not involved in the research told BBC News.

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