Eindhoven University of Technology: Without gasping for air safely in the artificial womb

An artificial uterus significantly increases the chances of survival for extremely premature babies. That is why researchers at TU Eindhoven are doing a lot of research on this topic. One of the biggest challenges is preventing the fetus from breathing oxygen just after birth, because that is harmful to the not yet mature alveoli. The solution? A wound spreader, coupling elements and a biobag filled with amniotic fluid.

The development of the artificial uterus has accelerated in recent years, not least because of the Perinatal Life Support partnership, which includes TU Eindhoven. According to Professor Frans van de Vosse (Professor of Cardiovascular Biomechanics within the Faculty of Biomedical Technology) and Guid Oei (Gynecologist and part-time Professor within the Faculty of Electrical Engineering), within ten years it should be possible to significantly increase the chances of survival and quality of life of extremely premature babies via a so-called incubator 2.0.

QUALITY OF LIFE
In the Netherlands alone, 700 children are born extremely prematurely each year – between 24 and 28 weeks. Almost half die, while a large proportion retain permanent health problems because organs have not yet matured. “Think of lung problems or brain damage,” clarifies Frank Delbressine (Assistant Professor of Industrial Design). “We want to increase both the life chances and the quality of life of newborn babies with an artificial uterus.”

Delbressine is the supervisor of PhD student Juliette van Haren. Together with a group of Industrial Design students, she is concerned with, among other things, the way in which childbirth should take place. One of the biggest challenges is to prevent the fetus from gasping for air just after birth (in this case by caesarean section). The birth procedure to the artificial uterus should be as natural as possible, which is why Van Haren is developing a safe way for the premature baby to be transferred from the natural uterus to the artificial uterus.

LUNG ALVEOLI NOT FULLY GROWN
“We want to prevent the fetus from breathing oxygen, because the alveoli are not yet mature and can be damaged. A 24-week-old baby belongs in an artificial amniotic fluid environment, and we’re trying to mimic that. The transition from the real uterus to the artificial one must occur in a way that the baby barely notices, both physically and mentally, that he or she is being taken to a different location,” explains Delbressine.

The principle works as follows: a so-called wound spreader holds open the wound created by the C-section, after which a biobag filled with artificial amniotic fluid is attached to the wound spreader via a connector. The baby can then be carefully transferred to the artificial uterus at the correct temperature via a glove in the biobag.

Delbressine: “A filled biobag may sound crazy or disrespectful at first, but this is exactly how the fetus is ‘wrapped up’ in the womb as well, we are trying to imitate that as real as possible.”

CERTIFICATION
The system that Van Haren is currently developing consists of several components. Think, for example, of a mechanism that supports the doctor during transfer, as the combination of fetus and fluid can become quite heavy.

Of all these parts, the wound spreader is already in medical use and therefore clinically certified. The rest of the system is completely new and must go through a rigorous clinical approval process. Delbressine: “That’s logical, what we are doing is brand new. Pioneering. It will therefore be years before we can actually start using this system.”

The two are in close contact with the working field, such as specialists from the Máxima Medical Center in Eindhoven. Van Haren: “It’s a nice interaction, we get a lot of feedback from doctors. They have the medical knowledge, we know how to design systems.”

SENSES
There is a lot involved in developing the artificial uterus itself. Elements must be taken into account that you might not immediately think about at first. Delbressine: “At 24 weeks, the senses are still developing, and babies are sensitive to light, sound and vibrations. The impulses they receive in the natural womb we try to imitate in the artificial womb. The senses need to be stimulated, but in such a way that the brain can handle it. This is still work in progress”

There is still a lot of work to be done before the system can actually be used. We’re talking years. For Delbressine and Van Haren, no problem. Their driving force is in helping children. Van Haren: “Improving the lives of premature babies and increasing their chances of living a beautiful life, that’s what we ultimately do it for.”

COOPERATION
Perinatal Life Support is a larger partnership that conducts research into a ‘Perinatal Life Support’ system. Partners are TU/e, the universities of Aachen and Milan, and the companies LifeTec Group and Nemo Healthcare. In 2024 the European funding (from Horizon 2020) ends, then the prototype of the artificial uterus must be ready. After that, the preclinical and clinical tests and the certification process will start.

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