VALENCIA, Spain—The Spanish experience in setting up the experimental model for an artificial placenta was presented by Elisenda Eixarch, MD, PhD, from the Fetal and Perinatal Medicine Research Group at Hospital Clinic – Universitat de Barcelona, Spain, at the 20th World Congress in Fetal Medicine.
From only 15 minutes of survival that they could achieve in March 2021, the team is now able to keep a sheep fetus alive in the artificial placenta for 14 days.
The first clinical trials, which will commence in the future, will determine the timing for real use, according to Dr. Eixarch.
When developing an artificial placenta system, Dr. Eixarch said, there are many problems that need tackling. If you try to solve these all at once, “the most probable thing is that you are going to fail, so you have to focus on specific problems.”
These problems are the transition of the fetus from the mother to the artificial placenta system and from the artificial placenta to the neonatal state, the protective environment, the monitoring of the functioning of the system, the extracorporeal circulation system, and the nutritional support of the fetus.
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For transition, though there seems to be no differences between surgical methods in terms of duration, Dr. Eixarch and colleagues found that the sequential microscan technique had better results in terms of Ph and fetal status.
In terms of protective environment, Dr. Eixarch compared 3 systems: the amniobox, the amniobag, and the amnioshell. “With the amnioshell, you can see the fetus moving, you can do ultrasound,” she said and also described the composition of the best amniotic fluid used in the amnioshell.
She also described the system they developed to monitor the fetus, which integrates all the information needed to contain the fetus in the environment and is accessible 24/7 by the monitoring researcher.
Finally, in terms of the extracorporeal circulation system, Dr. Eixarch said a safe anticoagulation system is needed to protect the fetus from hemorrhagic complications that occur, as well as hydrops.
The artificial womb extending fetal physiology has positive effects on survival and morbidity in experimental models, Dr. Eixarch concluded, providing potential future solutions for extreme prematurity.
There are currently 5 active experimental programs on artificial placentas and wombs in the world, with the longest survival time of 28 days achieved by researchers at the Children’s Hospital of Philadelphia in Pennsylvania.
Reference
Eixarch E. Artificial placenta: experience from Spain. Oral presentation at: 20th World Congress in Fetal Medicine; June 25, 2023; Valencia, Spain.
