Development of an Artificial Placenta

Fetal medicine is a rapidly progressing new field. Numerous fetal abnormalities have been accurately detected prenatally with recently developed technologies such as cardiotocography, ultrasonography and magnetic resonance imaging. It has long been recognized that some of these abnormalities are better treated in utero to achieve favorable outcomes; however, currently available techniques for fetal therapy have been proved to have a limited clinical effectiveness. For example, congenital diaphragmatic hernia in its severe form, which is basically lethal after birth, can now be repaired during fetal life by fetal surgery.1 This congenital defect causes lung hypoplasia, which is essentially untreatable after birth. Therefore congenital diaphragmatic hernia is a strong candidate for fetal surgery if it is clinically effective. However, due to the difficulty in controlling uterine activity following open fetal surgery, the technique has not yet been recognized as a standard approach for treating the disease. Indeed, uncontrollable uterine activity is one of the most troublesome complications of open fetal surgery in humans because premature delivery immediately after the surgery makes all the obstetrical and surgical efforts meaningless for the prognosis of the affected fetus. For researchers and clinicians in the field of perinatal medicine, it appears that the primate uterus is extraordinarily sensitive to external stimuli compared with that of other species such as the sheep. Therefore, for establishing fetal surgery as a standard clinical technique, it is extremely important to develop a new system for those fetuses unprepared for an extrauterine environment, which were obliged to be born due to a too sensitive uterus following fetal surgery. In this article, an approach for the extrauterine incubation of premature fetuses/the newborn is described. Incubation of a fetus with an artificial apparatus has been a dream of human beings for very many years. In 1932, in a novel titled Brave New World, Aldous Huxley described a kind of artificial placenta: