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A Volume-Adjustable Artificial Womb for Extremely Preterm Infants
Jan Heyer1, Franziska Schubert1, Alexander L Seitz1
1Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany.
Insights
Developing an artificial womb, this bridge-to-life technology supports extremely preterm infants by providing a physiological liquid environment for organ maturation. The system demonstrates adaptability to fetal growth and maintains stable conditions for up to 7 days.
Area of Science:
- Neonatal medicine
- Biomedical engineering
- Developmental biology
Background:
- Over 13 million children are born preterm annually, with prematurity causing 0.9 million global deaths.
- Extremely preterm infants (gestational age < 28 weeks) face organ failure and specific morbidities due to immaturity.
- Existing treatments for extreme prematurity have limited success in preventing mortality and long-term complications.
Purpose of the Study:
- To develop and evaluate an artificial womb and placenta technology as a bridge-to-life solution for extremely preterm neonates.
- To create a system that supports physiological organ maturation in a liquid environment, mimicking in utero conditions.
- To design an adaptable artificial womb capable of accommodating fetal growth over a defined period.
Main Methods:
- An artificial womb system was designed with adjustable inner sac volume (3.6–7.0 L) using fluid removal between chambers.
- A filtration and disinfection system was developed to manage metabolic waste and prevent phospholipid washout.
- In vitro testing was conducted over 7 days to assess temperature stability (36.8°C ± 0.3°C) and pressure integrity.
Main Results:
- The artificial womb maintained a stable temperature of 36.8°C ± 0.3°C without pressure loss for 7 days.
- The system demonstrated effective filtration, disinfection, and prevention of phospholipid washout.
- The volume variability of the artificial womb was sufficient to support physiological growth for 4 weeks.
Conclusions:
- The artificial womb technology shows promise as a bridge-to-life solution for extremely preterm infants.
- The system's ability to adapt to fetal growth and maintain physiological conditions is a significant advancement.
- Further development of this technology could reduce prematurity-related mortality and morbidity.
Abstract:
More than 13 million children are born preterm annually. Prematurity-related mortality accounts for 0.9 million deaths worldwide. The majority of those affected are Extremely Preterm Infants (gestational age less than 28 weeks). Immaturity causes organ failure and specific morbidities like germinal matrix hemorrhage, bronchopulmonary dysplasia, and necrotizing enterocolitis. Artificial womb and placenta technologies address these issues. As a bridge-to-life technology, they provide a liquid environment to allow organ maturation under more physiological conditions. The proposed artificial womb can adapt to fetal growth. Volume adjustment is achieved by removing fluid from the interspace between an inner and outer chamber. Results of the in vitro tests showed a temperature constancy of 36.8°C ± 0.3°C without pressure loss over 7 days. The volume of the inner sac was variable between 3.6 and 7.0 L. We designed a filtration and disinfection system for this particular purpose. This system has proven strong disinfection capabilities, effective filtering of metabolic waste, and the ability to avoid phospholipid washout. The presented artificial womb has sufficient volume variability to adapt to the physiologic growth of an extremely preterm neonate over a 4-week period. We regard this as an important step in the development of this bridge-to-life technology.
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