Conceptual Photograph: The Voorhes
Re-creating everything that happens inside the womb belongs firmly in the realm of science fiction. There’s still too much that scientists don’t know about the early stages of development, when fetal cells grow into organs, limbs, and tissues. But George Mychaliska thinks that creating an artificial version of the placenta, or at least replicating its most important function, is in reach. As a fetal and pediatric surgeon at the University of Michigan’s C.S. Mott Children’s Hospital, in Ann Arbor, he often sees premature babies who have left the womb too soon. Although modern medicine can save many of them, the chances of survival for extremely small preemies—those younger than 28 weeks, barely in their third trimester—remain slim. Of the survivors, many are left with long-term health problems. Lungs simply aren’t designed to breathe until the baby is close to full term, which is currently defined as 39 weeks, and even the gentlest techniques to assist breathing can damage the tissue.
“We’re in a catch-22 as baby doctors,” Mychaliska says. “If we don’t do anything, they die. If we want to save them… they may survive, but they likely will have varying degrees of lung disease from the treatment itself.”
For more than a decade, Mychaliska has been working on a solution: an artificial placenta to keep extremely young preemies alive until they can breathe on their own. Already, he’s proven that it can sustain premature lambs for several weeks. Building a breathing apparatus for a premature infant is not trivial, as the baby’s tiny size and fragile physiology pose both medical and engineering challenges. Mychaliska’s team has been adapting existing technology to work reliably with the skinniest of blood vessels and developing materials compatible with the unique biology of fetuses. Now, after several recent breakthroughs, Mychaliska thinks his team’s artificial placenta is only five years away from human trials.
Read my April 2021 cover story for IEEE Spectrum