Artificial placenta: Analysis of recent progress

Area of Science:

• Neonatal medicine
• Bioengineering
• Perinatology

Background:

• Extreme preterm birth (before 28 weeks) poses significant survival challenges.
• The "greyzone" (23-25 weeks) has high mortality due to immature organ systems.
• Advances in neonatal care have pushed survival limits to around 23 weeks gestation.

Purpose of the Study:

• To review the challenges and potential of artificial placenta (AP) technology for extremely preterm infants (EPIs).
• To discuss the current state of AP research, focusing on sheep models.
• To identify technical obstacles and future research directions for AP development.

Main Methods:

• Review of recent artificial placenta studies, primarily using ovine models.
• Comparison of different AP approaches and their technical feasibility.
• Analysis of the biological and developmental considerations for ex-utero support.

Main Results:

• Current AP research shows promise in supporting fetal lambs ex-utero.
• Significant technical hurdles remain in replicating the maternal-fetal interface.
• The shift towards viewing extremely preterm infants as fetuses is driving AP innovation.

Conclusions:

• The artificial placenta (AP) represents a promising frontier for managing extremely preterm infants (EPIs) in the critical "greyzone" of gestation.
• Overcoming technical challenges in AP development is crucial for improving outcomes for these vulnerable neonates.
• Further research is needed to translate AP technology from animal models to clinical application for previable infants.