Bringing a human life into this world is a difficult and painful process. A process that mothers endeavor in order to keep our race thriving. At times there can be several different complications in pregnancies that result in preterm infants being born.
Preterm infants are babies born alive before the 37 weeks of pregnancy are completed. A sub-category of preterm is ‘extremely preterm’ where the baby is born in less than 28 weeks of gestation. Preterm babies face many medical problems like anemia, hypoglycemia, brain and pulmonary hemorrhage to name a few, making their survival quite difficult.
The intensive neonatal care of these infants is taken by temperature-controlled incubators and oxygen ventilators that mechanically provide the environment of a mother’s womb. It is undoubtedly heart-breaking for a mother to witness her precious little angel struggling to survive especially those born before 28 weeks. Thankfully science comes to the rescue. Researches in the field of obstetrics (a study concentrating on pregnancy and childbirth) are developing new ways to artificially mimic the environment of a womb.
One recent breakthrough achieved in the field of obstetrics, published in the American Journal of Obstetrics and Gynecology, is by Matthew W. Kemp and colleagues. Kemp and his team successfully modified and adapted their previously created artificial placenta to support extremely preterm infants. In 2017, they had developed an ‘Ex vivo uterine environment’ (EVE) therapy, an experimental neonatal intensive care that performed gas exchange by membranous oxygenators attached to the umbilical cord. The EVE system looks like a transparent, pillow-sized bag filled with sterilized amniotic fluid, vital nutrients like amino acids and antibiotics.
The researchers used preterm lamb fetuses for their experiments and established the stable physiological parameters needed to maintain the fetuses for an initial 48 hours. They further improved the conditions and set up to maintain the fetuses in EVE therapy for 1 week. Kemp and his team’s work in 2019 mainly focused on establishing the stable conditions needed to maintain extremely preterm infants. For this they experimented on 8 ewes and maintained the fetuses for 120 hours with real-time monitoring of physiological variables. The modifications that the team made were (1) gas exchange was enhanced and only a single high-performance membrane oxygenator was used, (2) the volume of the synthetic amniotic fluid was decreased, (3) frequent replacement of UV-sterilized of amniotic fluid was made ( every 6 hours) and (4) artery and vein catheters were not used to reduce stress on the fetus. The artificial placenta used was mainly composed of an inflow tube, membrane oxygenator and outflow tubes. Seven of the eight fetuses completed the 120 hour experimental period in the EVE therapy. The seven EVE animals were healthy and showed no signs of premature medical conditions.
Preterm births are a global problem with increasing numbers yearly. Although human trials for this technology and others similar to it are still years in making, there is new hope for preterm babies. The medical problems that a premature baby may have to face can be reduced if not eliminated by EVE therapy. In the end, a promise of a normal, healthy life is all a mother wants for her child.
Forman Christian College University, Lahore Pakistan