Tag Archives: premature birth

Image courtesy of Children's Hospital of Philadelphia.

Artificial womb-like environment helps premature lamb mature for 4 weeks

Premature babies often can’t survive because their tiny organs haven’t had enough time to develop. Doctors at the Children’s Hospital of Philadelphia (CHOP) want to give these babies a fighting chance. They’ve recently demonstrated a womb-like environment filled with a substance that mimics the prenatal fluid. The system was tested on lambs which showed normal growth and looked healthy after a few weeks of gestating in the womb-like sac.

Image courtesy of Children's Hospital of Philadelphia.

Image courtesy of Children’s Hospital of Philadelphia.

This extra-uterine support system is the culmination of three years of hard work and the last of four prototypes. At first, the team led by Alan W. Flake, MD, a fetal surgeon at CHOP, started with a glass incubator tank, then gradually improved their design borrowing ideas here and there from previous work done by other researchers who had been working on artificial wombs or similar life support systems.

The system is made up of a fluid-filled container attached to custom-tailored machines that provide physiological support. Sensors and automation ensure the environment is almost perfectly sterile and the temperature is constant. The device, however, doesn’t use external pumps to circulate blood nor ventilators. Because the heart and lungs are so underdeveloped, even a gentle artificial pressure is enough to break the fragile organs. Immature lungs can’t breathe atmospheric oxygen.

Instead, the fetal lambs breathe amniotic fluid as they normally would in the womb and their own hearts pump blood through the umbilical cord that’s connected on the other end to a gas exchange machine placed outside the container bag. A low-resistance external oxygenator substitutes for the mother’s placenta in exchanging oxygen and carbon dioxide.

The team tested its extra-uterine device on eight preterm lambs which were physiologically equivalent to a 23- or 24-week-gestation human infant. The limit of survival of premature human infants is about 22 to 23 weeks of gestation. At this age, an infant weighs only 0.6 kilograms (a little more than a pound) and only has a 30 to 50% chance of survival, depending on the severity of the prenatal birth. If they do survive, severely premature babies often face chronic health problems due to organ immaturity, for all of their adult lives. Disability is very common and the morbidity risk is much higher than average.

So, the goal is to support infants from 23 weeks to 28 weeks gestational age; at 28 weeks they cross the threshold away from the most severe outcomes.

“These infants have an urgent need for a bridge between the mother’s womb and the outside world,” said Flake. “If we can develop an extra-uterine system to support growth and organ maturation for only a few weeks, we can dramatically improve outcomes for extremely premature babies.”

These findings shine a ray of hope for the 30,000 or so critically preterm babies that get born yearly in the United States. After four weeks of development inside the fluid-filled container, the lambs opened their eyes and seemed healthy. The lambs grew wool, became more active, and had normal growth, neurological function, and organ maturation, as reported in Nature Communications. 

The womb-like environment looks completely out of this world. Once you get past the creepy SciFi vibes, it's not so bad. Lambs developed inside them for up to 28 days. Credit: Children's Hospital of Philadelphia.

The womb-like environment looks completely out of this world. Once you get past the creepy SciFi vibes, it’s not so bad. Lambs developed inside them for up to 28 days. Credit: Children’s Hospital of Philadelphia.

The team will next work on refining the system and prepare it for human infant use. A prenatal infant is only one-third the size of an infant lamb so the whole container and life-support system needs to seriously downsized. Doctors are also interested in adding some subtleties like audio recordings that simulate sounds a fetus would normally hear in the womb, like the mother’s heartbeat. Parents would also be able to watch their babies mature through an imaging system.

“We’ll try to make it an environment that is parent friendly, a much less stressful situation than seeing their fetus on an incubator and exposed bed, having IVs started and experiencing painful and uncomfortable stimuli like bright lights,” Flake told ResearchGate. 

Flake expects their device could appear in clinical care units in a decade if the results can be adapted for humans. If successful, not only will it save the lives of thousands of babies, it would also help cut down on the estimated $43 billion annual medical costs of prematurity in the U.S.

“This system is potentially far superior to what hospitals can currently do for a 23-week-old baby born at the cusp of viability. This could establish a new standard of care for this subset of extremely premature infants,” Flake said in a statement.

Premature baby born

Prematurity is the leading cause of death in infants. What you need to know

Premature baby born

Image: Pixabay

Today is World Prematurity Day –  a global effort to raise awareness about the deaths and disabilities due to premature births. Each year around the world, 15 million babies are delivered ahead of term and 1 million children die before their fifth birthday from related complications. Some who make it past this dangerous threshold might get to live with serious disabilities.

A baby is considered premature if born before 37 weeks in the womb. Pakistan, India and Nigeria account for more than 60 per cent of the total number of babies born prematurely each year and 50 percent of the deaths due to preterm complications, but the U.S. doesn’t favor too well either. Each year, 1 out of every 10 infants is born prematurely in the United States.  March of Dimes,  an international organization focused on making sure every baby is born healthy and full term, rated the U.S. as mediocre when averting premature terms comes. Some states got the lowest grade possible.

What causes premature birth

There are a slew of factors that can lead to a baby delivered before term. These include:

  • Having a very full and stretched womb (uterus). Unfortunately, this is most common when the mother is carrying twins or more.
  • Cervical weakness, or a short cervical length. A sonographer can pick up these abnormalities as early as mid-pregnancy.
  • A history of spontaneous premature birth.
  • A bacterial infection in the bag containing the waters or in the amniotic fluid itself.
  • Your waters breaking early.
  • Heavy bleeding.
  • Some abnormalities of the womb.
  • Emotional problems.
  • Smoking and drugs, particularly cocaine.
  • Being overweight or underweight.
  • Being older (past 32 years of age).
  • IVF induced pregnancies.

Making sure a mother is as healthy as she can be, both physically, mentally and emotionally, is the best way to avert a premature birth. Sometimes, doctors can anticipate a pre-term birth. In these cases they can take action like progesterone therapy or low-dose aspirin for women at high risk of preeclampsia, a condition associated with preterm birth.  If it happens, intensive care is required especially for those babies born very early (before 28 weeks). In poor regions of the world where access to medical care is limited, if not absent altogether, experts advise other caring methods like kangaroo mother technique, which involves immediate skin-to-skin contact between mother and baby. This keeps the baby warm and keeps the mother’s attention on her baby, which prompts her to feed the baby more often.

To raise awareness for  World Prematurity Day, there are various rallies held through the US and elsewhere. The Empire State Building in New York will be lit in purple, the official colour of World Prematurity Day. Similarly, the Bosophorus Bridge in Turkey and the Heidelberg Castle in Germany will also turn purple tonight.

From the March of Dimes:

  • Prematurity is the No. 1 cause of death in infants
  • The premature birth rate has risen by 36% over the last 25 years
  • Prematurity costs $26 Billion nationwide
  • November is Prematurity Awareness Month

10 year old girl gives birth, but authorities can’t step in

It just saddens me to find out about things like this: in Colombia, a ten year old girl has given birth to another baby girl, making her one of the youngest mothers to ever live.

A girl from the Wayuu tribe. Source

According to Univision’s Primer Impacto, the girl, which was not named for obvious reasons, arrived in hospital in a great deal of pain, crying and suffering as a result of the contractions. She delivered by a C-section, which is not that uncommon for very young mothers. The good news is that the baby girl is perfectly healthy, and from what doctors can see, she has every reason to grow up just fine – and this is pretty rare in these cases.

“These girls are not ready to be pregnant. Their bodies are not mature…They may be able to get pregnant, but being able to have a baby is a whole other situation.”, said Dr. Frederick Gonzalez, a clinical professor of obstetrics and gynecology at NYU Langone Medical Center.

The police don’t know anything about the father and they can’t do anything to find out either. The thing is, the girl is from Manaure, a town in the Colombian Department of La Guajira, and she is a member of the Wayuu people, a tribe in northern Colombia, which means that they have their own jurisdiction, and the police or other authorities can’t do anything to intervene.

“We’ve already seen several cases [of pregnancy] in girls of the Wayuu ethnicity…When in fact [the girls] should be playing with dolls, they are having to care for a baby. This is shocking.”, declared Efraín Pacheco Casadiego, director of the hospital where the girl gave birth.

So what do you feel about this? It seems natural to leave the tribe to govern for itself and not step in, but then again, a ten year old giving birth is not really natural. The youngest mother ever was Lina Medina, from Peru, who gave birth at 5 years and 7 months.