According to the WHO, 15 million babies are born prematurely each year, of which 1 million die due to complications. The need to reduce neonatal mortality has culminated in the development of artificial amnion and placenta technology, commonly known as the ‘Artificial Womb’, which provides an environment for the ectogestation of the foetus. Ever since 1958, when Westin et al. developed the first artificial womb by cannulation of umbilical vessels, this technology has shown remarkable potential for improvement of clinical outcomes in critically preterm children. Currently, working models of the technology include EXTra-uterine Environment for Neonatal Development (EXTEND) by Children’s Hospital of Philadelphia, Ex-Vivo uterine Environment (EVE) by Tohoku University, and University of Western Australia1. The world’s first artificial womb facility – EctoLife – was launched by a Berlin, Germany based Hashem Al-Ghaili.
The ‘Womb’ has been designed to simulate all the necessary physiological mechanisms during gestation. Gaseous exchange is performed via extracorporeal membrane oxygenation. A pumpless arteriovenous circuit is deployed that drives blood exclusively from the foetal heart and is combined with a low-resistance oxygenator. Waste disposal is carried out through dialysis. A polyethylene film-based biobag is used, which is responsible for sterility, size adjustment, and fluid and space volume efficiency. It can be modified to mimic the dimensions and shape of the uterus with more accuracy, thus providing an analogous alternative to the real womb3.
Considering the incidence and mortality rates of premature deliveries throughout the world, artificial womb technology (AWT) is no less than a boon. AWT provides the innate environment of a human womb, thereby reducing respiratory struggle incompatible with the premature lung of the foetus. The impervious, sealed design mimicking the amniotic cavity also reduces the risk of infection. It can be a suitable alternative in cases of placental insufficiency, which can lead to preterm labour and intrauterine growth retardation.