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Review
. 2024 Feb 15:12:1360111.
doi: 10.3389/fped.2024.1360111. eCollection 2024.

Transferring an extremely premature infant to an extra-uterine life support system: a prospective view on the obstetric procedure

Juliette S van Haren  1   2 , Frank L M Delbressine  1 , Mark Schoberer  3 , Arjan B Te Pas  4 , Judith O E H van Laar  2   5 , S Guid Oei  2   5 , M Beatrijs van der Hout-van der Jagt  2   5   6
Affiliations
Review

Transferring an extremely premature infant to an extra-uterine life support system: a prospective view on the obstetric procedure

Juliette S van Haren et al. Front Pediatr. .

Abstract

To improve care for extremely premature infants, the development of an extrauterine environment for newborn development is being researched, known as Artificial Placenta and Artificial Womb (APAW) technology. APAW facilitates extended development in a liquid-filled incubator with oxygen and nutrient supply through an oxygenator connected to the umbilical vessels. This setup is intended to provide the optimal environment for further development, allowing further lung maturation by delaying gas exposure to oxygen. This innovative treatment necessitates interventions in obstetric procedures to transfer an infant from the native to an artificial womb, while preventing fetal-to-neonatal transition. In this narrative review we analyze relevant fetal physiology literature, provide an overview of insights from APAW studies, and identify considerations for the obstetric procedure from the native uterus to an APAW system. Lastly, this review provides suggestions to improve sterility, fetal and maternal well-being, and the prevention of neonatal transition.

Keywords: APAW; artificial placenta; artificial womb; extra-uterine life support; fetal physiology; neonatal transition; perinatal life support; transfer procedure.

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Conflict of interest statement

The authors JvH, FD, SO have a patent application entitled “Transfer of a preterm baby from a natural womb” (no. WO2023027584A1). The authors JvH, FD, MvH, SO have a patent application entitled “Transfer of a preterm baby from a natural womb” (no. WO2022066014). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The physiology involved at birth that results in neonatal transition, the different modes of delivery, and potential obstetric approaches for a transfer to an APAW system. Each has a relative timescale (–191).
See this image and copyright information in PMC

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