Barcelona researchers to create artificial placenta for premature babies

AN ARTIFICIAL placenta connected to the umbilical cord could help very premature babies not only to survive, but to develop healthily, according to researchers in Barcelona.

BCNatal, a consortium formed from CaixaBank's humanitarian and social foundation and the Sant Joan de Déu and Clínic hospitals, believe that if their experiment proves successful, it could be in use within four years.

Dr Eduard Gratacós explains that an 'exo-placenta' would allow babies born at less than six months' gestation to develop and grow in a 'natural environment', in the same way as they would if they had stayed in the womb.

It would 'radically improve' the prognosis for these infants, as it is less invasive than being intubated in an incubator.

An estimated 25,000 babies a year are born in Europe at 26 weeks or less, and of those who survive, between 75% and 95% suffer serious after-effects, which are often permanent – a situation that has shown little improvement in the last 20 years.

At this stage of gestation, babies typically only weigh around 500 grams (1.1lb), or about one-sixth of a healthy full-term birth weight, and vital organs such as the brain, lungs, intestines and cardiovascular systems are not yet fully formed.

“We're talking about a technology that favours nature, where conditions are as similar as possible to those in the mother's tummy,” says Dr Gratacós.

“For example, they're in liquid, and their breathing and feeding is still via umbilical cord – forcing their lungs and intestines to function when they are so underdeveloped can cause problems and illnesses.

“The idea is not just to keep the baby alive, but to give the baby optimum quality of life.”

A sac made from 'bio-compatible material' containing a warm liquid as close as possible to amniotic fluid, and with the umbilical cord still attached to the infant and connected to a system that supplies oxygen and nutrients, monitored constantly once stable, would keep the baby safe and continuing to develop normally for up to three or four weeks.

This length of time would bring them to approximately seven months of gestation in later cases – a term after which a baby could be born in reasonably good health.

During these three or four weeks, very small operations 'using microscopic robotic arms' for movements which were 'very accurate, to the millimetre' could be carried out.

The placenta would be transparent, resting on specially-made supports, so the baby could be seen through it, but it would have to be kept away from light. 

For a baby's healthy cognitive development, the physical bond with the mother before birth is 'very important', says Dr Gratacós, but the artificial placenta would be designed to recreate the sounds and sensations the foetus experiences whilst in the womb – such as the mother's heartbeat.

Research and available components have already shown that a prototype would now be possible, and the La Caixa Foundation has provided funds which will be used for the next stage: Creating a blueprint to try out with unborn lambs.

This early phase, which will take from two-and-a-half to three years, will allow scientists to study survival rates of each premature lamb foetus and whether or not their organs develop properly.

The second phase will involve examining the long-term development of the brain, heart, lungs and metabolic system, and improvements will be introduced as needed in the nutrition system and environment.

Only then, and after a full ethics inquiry, will the invention be moved to the clinical trials stage, where premature human babies are placed in it – always with the fully-informed consent of the immediate family.

Dr Gratacós' team will be made up of between 25 and 50 specialists and researchers at any one time, from different, relevant disciplines, and with up to 300 others working in peripheral rôles.

If all goes according to plan, he expects the artificial placenta to be in mainstream use within four to six years.