In search of an artificial placenta to save very premature babies

Science

By CAPosts 03 December, 2020 - 10:51am 56 views

Sheltered in a bag about three centimeters thick, floating in amniotic fluid in the heat of the mother's uterus and fed by an umbilical cord, fetuses grow for about 40 weeks before being born. Sometimes, however, delivery occurs a few weeks earlier and newborns require a few days in the incubator to finish maturing. But there are more complex cases, extreme premature babies, who are born before 26 weeks of gestation and carrying them out poses a challenge to biology: mortality can reach 75% and most of the survivors suffer sequelae. To overcome these natural difficulties, a group of researchers from the Hospital Clínic and Sant Joan de Déu in Barcelona have started a pioneering trial in Europe to design an artificial placenta to shelter extremely premature babies.

Premature babies: coming home The loneliness of being born early in the middle of the

pandemicThe fetus is ready to live inside its mother . Sometimes we can help you live, but there is a time when biology tells us that we can't get through, because we don't have lungs to breathe or intestines to eat. We are talking about not continuing to use technology against nature, but to go in favor of nature. That they live in conditions as fetal as possible, as if they were inside their mother ”, explains Eduard Gratacós, head of the project and director of BCNatal, a reference center for neonates at the Clínic and Sant Joan de Déu.

In Europe some 25,000 babies a year before the 26th week of pregnancy and between 75% and 95% will carry serious consequences throughout their lives due to prematurity. “When a baby is born premature, we are concerned about his lungs, we have to force them and it can cause pulmonary bronchodysplasia. We are concerned about the intestine because it is not developed and can cause inflammation. We are concerned about your cardiovascular or brain system. His neurological development is threatened, he has neither 30% of neurons nor neuron connections. Very subtle changes in oxygen that we do not even see, can cause sequelae ”, warns the specialist.

The plan of the Gratacós team is to design an artificial biobag that replicates the maternal placenta to be able to house very premature babies for a few more weeks to facilitate their process ripening. For now, the prototype is very primary and is being tested on sheep fetuses. But the idea is that, "in five or six years", they can develop an artificial placenta in which to host babies for three or four weeks. Around the world there are three other research projects in search of an artificial placenta, two in the United States and another by scientists from Australia and Japan. All three are more advanced than the Gratacós prototype, but no one has yet begun to test it with human fetuses.

The Spanish researchers' biobag will be translucent, although they will have to protect it from light to resemble the maternal uterus. Through the actual umbilical cord they will deliver nutrients and oxygen to the baby. “We will put it in a bag that reproduces the conditions of the warm amniotic fluid, maintaining strict temperature control. We will reproduce the sounds of the mother's body and study how this helps modulate the brain. We will have it monitored with biosensors and controlled with non-invasive ultrasound scans, ”says Gratacós. If they have to touch the baby, the researchers have robotic arms designed for fetal operations. "Our access to it is infinitely superior to what we have now," says the researcher.

"What we do is replace an organ of the fetus. During a stage of our life, we had an organ called the placenta and it is as important as a kidney ”, synthesizes Gratacós. The La Caixa Foundation will invest seven million euros in the development of the project that, in a first phase, will deploy the experimental design with sheep fetuses. The second phase seeks to evaluate the long-term effects on brain, heart, lung and metabolic development before applying it to clinical practice. All the research is supervised by a panel of external experts.

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Source: Elpais

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