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Artificial placenta: Analysis of recent progress.

Stephen D Bird1

  • 1Department of Obstetrics and Gynaecology, The University of Melbourne, Australia.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|November 29, 2016
PubMed
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The artificial placenta (AP) offers a potential solution for extremely preterm infants (EPIs) born before 23 weeks. This technology aims to support fetal development ex-utero, addressing limitations in current neonatal intensive care.

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.
Keywords:
CoagulationExtracorporeal life supports (ECLS)Extracorporeal membrane oxygenation (ECMO)Extremely preterm birthFetusGreyzoneHaemocompatibleHaemodialysisHaemodynamicHomeostasisInflammationKidneyLifePodLungOxidationPlacenta

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  • 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.