Imagine a world where extremely premature babies have a better chance of survival and healthy development. This vision is becoming a reality thanks to groundbreaking advancements in medical technology. Researchers have developed an artificial womb capable of sustaining and nurturing a premature fetus outside the mother’s body. This innovation, tested successfully on lamb fetuses, represents a significant leap forward in neonatal care.
The artificial womb, known as the ‘ex vivo uterine environment’ or EVE, is designed to mimic the natural conditions of a mother’s womb. It is essentially a transparent, pillow-shaped bag filled with a sterile artificial amniotic fluid. This fluid is continuously cycled, filtered, and replenished to create a stable environment for the developing fetus. The EVE system aims to provide a more natural alternative to traditional incubators used in neonatal intensive care units.
A typical pregnancy lasts around 40 weeks, but babies born before 37 weeks are considered premature. While medical advancements have improved survival rates, babies born extremely prematurely, especially before 28 weeks, face significant challenges. These infants often struggle with underdeveloped organs, leading to high mortality rates and potential lifelong health issues.
One of the main challenges in developing an artificial womb is replicating the complex environment of the uterus. In utero, a fetus is surrounded by amniotic fluid and relies on a shared circulatory system with the mother. This system, facilitated by the placenta and umbilical cord, ensures the fetus receives oxygen and nutrients while removing carbon dioxide. Replicating this intricate process outside the womb has been a focus of research for over 50 years.
The EVE system uses a gentle oxygenator that relies on the fetal heartbeat to maintain circulation without harming the heart. Essential nutrients and antibiotics are delivered intravenously, mimicking the support a fetus would receive from the mother’s body. This setup allows the fetus to continue developing as it would naturally.
In 2017, researchers successfully kept premature lamb fetuses alive and developing normally for up to four weeks using the EVE system. One lamb, not used for further study, was bottle-raised and thrived beyond a year. In 2019, a collaborative effort between the University of Western Australia and Tohoku University Hospital in Japan achieved a milestone by sustaining lamb fetuses at the equivalent of 24 weeks of human gestation for 120 hours. These lambs continued to develop as they would in the womb, even growing wool.
Sheep are often used in prenatal research because their developmental processes closely resemble those of humans. Additionally, sheep have a shorter gestation period, allowing researchers to study developmental stages more quickly.
While the idea of artificial wombs may seem like science fiction, it’s important to temper expectations. So far, this technology has only been tested on sheep and on fetuses already in development. Creating a fully developed animal from an embryo remains a distant goal. However, the potential for this technology to improve outcomes for premature human babies is promising and could revolutionize neonatal care worldwide.
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Conduct research on the current state of artificial womb technology, focusing on the EVE system. Prepare a presentation that outlines the key features, benefits, and challenges of this technology. Present your findings to the class, highlighting how this innovation could impact neonatal care.
Participate in a class debate on the ethical considerations surrounding the use of artificial wombs. Consider topics such as the potential impact on traditional pregnancy, parental rights, and long-term societal effects. Prepare arguments for both sides and engage in a thoughtful discussion with your peers.
Analyze a case study of a premature birth and the challenges faced by the infant and medical team. Discuss how the EVE system could have altered the outcome. Reflect on the limitations of current neonatal care and how artificial wombs might address these issues.
Work in groups to design a conceptual prototype of an artificial womb system. Consider the technological, biological, and ethical aspects of your design. Present your prototype to the class, explaining how it improves upon existing models and addresses current challenges in neonatal care.
Draft a research proposal aimed at advancing artificial womb technology. Identify a specific aspect of the EVE system or a related area that requires further investigation. Outline your research objectives, methodology, and potential impact on neonatal care. Share your proposal with the class for feedback.
I know this looks pretty unusual, but what you’re looking at is actually a significant advancement in medicine. Researchers have created an artificial womb that can successfully keep an extremely premature fetus alive and developing normally—a lamb fetus, to be specific. This latest development in artificial placenta-based life support technology is an update to something called the ‘ex vivo uterine environment’ or EVE. It’s a bag that acts as an external womb, providing all the physical support an animal would receive in utero. The hope is that it could provide a more natural—and therefore also more successful—alternative to the incubator, the standard clear plastic box used to hold babies in healthcare environments like neonatal intensive care units.
A typical pregnancy lasts about 40 weeks, and any baby born before the 37-week mark is considered premature. Babies are technically able to survive outside the womb at about 21-24 weeks, but that’s the extreme edge of viability; those babies are considered extremely premature. There’s a reason that one of the leading causes of death in newborns is being born prematurely—babies are really hard to keep alive outside the womb before a certain stage in their development. Even with the advances in healthcare we’ve seen throughout the last several decades, like artificial airways and better ways to administer IV fluids to infants, infant mortality for babies born before 28 weeks remains as high as 50%. For babies born on or before the edge of viability, which is about 24 weeks gestation, mortality after premature birth is even higher. Those who do survive premature birth are likely to suffer from lifelong disabilities or chronic health conditions as a result of stunted organ development, so it makes sense that we’re looking for a better way to keep babies alive and healthier when they should still be in the womb.
One of the main barriers to a successful artificial womb, which has been the subject of study for over 50 years, is that babies in utero are surrounded by amniotic fluid. That’s why their lungs don’t work properly before 37 weeks, and instead of breathing, they benefit from a complex shared circulatory system—they’re attached by their umbilical cord and the placenta to their mother, whose heart function keeps blood flowing between the two, keeping the fetus oxygenated and removing carbon dioxide. This is why helping premature babies ‘breathe’ outside the womb is such a challenge. Existing pumps that keep gases flowing through the baby’s body present the problem of potentially damaging its heart—one of the many challenges in healthcare for premature babies.
Successful artificial wombs, like EVE, take inspiration from nature—they look like a transparent, pillow-shaped plastic bag filled with sterile artificial amniotic fluid that gets cycled out, filtered, and cycled back in. It relies on a novel, gentle oxygenator that uses just the fetal heartbeat to create successful circulation without causing any damage. The fetus receives essential amino acids via IV to replace the nutrients that would normally be provided by the mother’s body, along with antibiotics, also via IV, to protect it from infection, similar to how the mother’s immune system would work.
A team in 2017 kept premature lamb fetuses alive and developing normally for up to four weeks in an artificial womb, and one of the lambs that was not euthanized for further study was instead bottle-raised and is still alive, over a year after emerging from the bag! In 2019, a joint research team between the University of Western Australia and Tohoku University Hospital in Japan successfully kept extremely pre-term lamb fetuses—at the equivalent of 24 weeks of human gestation—alive for an unprecedented 120 hours. The lambs even continued to develop wool, just as they would have normally in utero.
You may be wondering why scientists are using lamb fetuses. Sheep are a commonly used model organism when studying prenatal development because they undergo many of the same processes in the womb as human babies, but they also grow faster than the typical nine months, allowing researchers to study the same stages and mechanisms of development at a slightly faster pace.
If this artificial womb technology sounds like science fiction, it’s important to remember that we shouldn’t get ahead of ourselves. For starters, this artificial womb has only been tested so far on sheep and only on already developing fetuses. Growing a whole animal from scratch—that is, from an embryo—is an entirely different story and something we’re quite far off from achieving. However, hopefully, this technology isn’t too far away from being implemented with premature human babies, improving outcomes for preemies and their families all over the world.
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Neonatal – Relating to newborn children, particularly the first few weeks after birth – The neonatal period is critical for the development of the immune system in mammals.
Womb – The uterus; the organ in female mammals where offspring are conceived and in which they gestate before birth – The study focused on how environmental factors affect the development of the fetus within the womb.
Fetus – An unborn offspring of a mammal, in particular an unborn human baby more than eight weeks after conception – Researchers are investigating how maternal nutrition impacts fetal growth and development.
Amniotic – Relating to the amnion, a membranous sac that surrounds and protects the embryo or fetus in the womb – Amniotic fluid plays a crucial role in cushioning the fetus and allowing for proper musculoskeletal development.
Premature – Occurring or done before the usual or expected time, particularly in reference to birth – Premature infants often require specialized medical care to support their development outside the womb.
Placenta – An organ in the uterus of pregnant mammals that nourishes and maintains the fetus through the umbilical cord – The placenta is essential for the transfer of oxygen and nutrients from the mother to the fetus.
Nutrients – Substances that provide nourishment essential for growth and the maintenance of life – Adequate maternal intake of nutrients is vital for the healthy development of the fetus.
Circulation – The movement of blood through the heart and blood vessels, distributing nutrients and oxygen to, and removing waste products from, the body’s tissues – Proper fetal circulation is crucial for delivering oxygen and nutrients to developing tissues and organs.
Research – The systematic investigation into and study of materials and sources to establish facts and reach new conclusions – Recent research has provided new insights into the genetic factors influencing fetal development.
Development – The process of growth and differentiation by which an organism progresses from a single cell to its mature form – The development of the human brain begins early in the fetal stage and continues well after birth.
