Development of the Artificial Womb
Purpose of Review
Prematurity is a global health problem representing one of the most significant causes of morbidity and mortality in children. The concept of an artificial womb has been explored as an innovation which could substantially improve clinical outcomes in preterm patients by offering the ability to support growth and development of the neonate in a manner consistent with fetal physiology. This review will address the contemporary literature exploring the development of the artificial womb, with a focus on promising new breakthroughs in the field.
Our laboratory has reported the development of an artificial womb incorporating the critical components of intrauterine physiology, namely sterile fluidic incubation of the isolated fetus as well as perfusion and gas exchange using a pumpless extracorporeal circuit. We have demonstrated support of fetal lambs for up to 4 weeks with stable hemodynamics and normal growth and development.
The artificial womb represents unprecedented potential for improvement in clinical outcomes in critically preterm infants. Recent studies have demonstrated promising results in preclinical animal models, supporting the translation of this technology to human clinical trials.
KeywordsExtracorporeal oxygenation Fetal physiology Umbilical cannulation
Compliance with Ethical Standards
Conflict of Interest
Emily A. Partridge reports she has a patent WO2014145494 A1 issued to Children’s Hospital of Philadelphia.
Marcus G. Davey reports he has a patent WO2014145494 A1 issued and a patent PCT/US16/38045 pending.
Alan W. Flake reports he has a patent WO2014145494 A1 issued and a patent PCT/US16/38045 pending.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.March of Dimes; Partnership for Maternal, Newborn, and Child Health Save the Children, WHO. Born too soon: the global action report on preterm birth. Geneva: World Health Organization; 2012.Google Scholar
- 4.• Anderson JG, Baer RJ, Partridge JC, et al. Survival and major morbidity of extremely preterm infants: a population-based study. Pediatrics. 2016;138(1):e20154434. This study illustrates the unmet need of extreme prematurity with recent assessment of associated mortality and morbidity CrossRefPubMedGoogle Scholar
- 19.• Bryner B, Gray B, Perkins E, et al. An extracorporeal placenta supports extremely premature lambs for one week. J Pediatr Surg. 2015;50(1):44–9. This study describes an alternate approach for non-physiologic support of the extreme premature infant utilizing veno-venous ECMO and tracheal occlusion CrossRefPubMedGoogle Scholar
- 20.•• Partridge EA, Davey MG, Hornick MA, et al. An extra-uterine system to physiologically support the extreme preterm lamb. Nat Comm. 2017;8:15112. https://doi.org/10.1038/ncomms15112. This study describes the first physiologic system capable of long-term support of the extreme premature lamb. CrossRefGoogle Scholar