Report of an Experiment With a Fetal Ex-Utero Support System in Piglets

Report of an Experiment With a Fetal Ex-Utero Support System in Piglets

Extreme prematurity remains one of the leading causes of neonatal death. An ex-utero treatment strategy that allows the fetus to develop beyond this period until capable of tolerating the transition to post-natal physiology would significantly impact the quality of care offered for this pre-viable p...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) Vol. 15; no. 4; p. e38223
Main Authors: Abrao Trad, Ayssa T, Buddington, Randal, Enninga, Elizabeth, Duncan, Jose, Schenone, Claudio V, Mari, Giancarlo, Buddington, Karyl, Schenone, Mauro
Format: Journal Article
Language:English
Published: United States Cureus Inc 27-04-2023
Cureus
Subjects:
Amniotic fluid
Catheters
Experiments
Fetuses
Gestational age
Healthcare Technology
Hogs
Intubation
Lungs
Newborn babies
Obstetrics/Gynecology
Pediatrics
Physiology
Premature babies
Surgical apparatus & instruments
Umbilical cord
Uterus
Veins & arteries
Ireland
ex-vivo support
prematurity
artificial uterus
fetus
artificial placenta
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Summary:Extreme prematurity remains one of the leading causes of neonatal death. An ex-utero treatment strategy that allows the fetus to develop beyond this period until capable of tolerating the transition to post-natal physiology would significantly impact the quality of care offered for this pre-viable patient population. In this study, we report our experience with an ex-utero support system for fetal pigs with the goal of support and survival for eight hours. Our experiment included two pigs at a gestational age equivalent to a 32-week human fetus. Following ultrasound assessment and delivery via hysterotomy, the fetuses were transferred to a 40 L glass aquarium filled with warmed lactated Ringer's solution and connected to an arteriovenous (AV) circuit that included a centrifugal pump and a pediatric oxygenator. Fetus 1 was successfully cannulated and survived for seven hours (expected maximum duration of eight hours). Fetus 2 died shortly after hysterotomy, secondary to failure at the cannulation stage. Our results suggest that ex-utero support of the premature fetal pig is feasible, contributing to a scarce body of evidence. However, further studies are needed before effectively translating an artificial placenta system into the clinical arena.
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.38223