Artificial wombs—where are we?
Preterm birth before 37 weeks gestation, is the principal cause of death among newborns globally. The swift improvement of NIC, however, was an example of medicine overwhelming some of the biological body’s natural vulnerabilities. The survival probabilities for preterms in developed countries had been regularly improving over the last few decades. So much so that the survival of very premature neonates, born at 28 weeks or less, is no longer wholly irregular. (1)
‘Infant incubators’ have supported preterms born as early as 21 weeks and 6 days. However, survival this premature is not the standard. A recent study announced a survival rate of only 0.7% among preterms born at 22–23 weeks. There is no hope of endurance before this point. Preterms on the viability threshold that survive birth often develop difficulties, ending in severe disability or death.
In the last 20 years, there has been a 44% rise in preterms born at 22–25 weeks lasting long enough to receive NIC, but the pattern of mortality and balance with severe long-term health problems has not meaningfully improved for some time. (2)
Limitations of neonatal intensive care:
The existence and severity of difficulties associated with preterm birth drop markedly with increased gestation. Neonates born before 26 weeks gestation persist unlikely to survive common complications. Around 50% of surviving preterms at 26 weeks have a critical long-term impairment.
This increases to 75% among those born at 23 weeks. The biggest problems plaguing preterms include undeveloped lungs and respiratory problems, circulatory problems creating low blood pressure and oxygen loss and an underdeveloped sense to swallow or absorb. These difficulties are almost certain before 26 weeks. (3)
They can be succeeded by providing mechanical ventilation, supplying oxygen, using outside pumps to aid circulation and nasogastric feeding. These functions are all interventions promoted in infant incubators, and they each bring risks and limitations. Mechanical ventilation and the regulation of oxygen can prevent further lung development or damage the lungs. Outside aids for circulation can cause heart failure by causing imbalances in blood flow.
Nasogastric feeding provides a high risk of necrotizing enterocolitis (death and leakage of intestinal tissue) and infection. Due to the risks and conditions of interventions, some scientists think the clinical possibilities of NIC have been drained.
There is only so much medicine can make for a neonate born without the potential for an independent life. This is why between 60% and 80% of NIC deaths happen after the withdrawal of interventions. Conventional NIC also promotes ethical concerns.
When treatment is suppressed, as is often the crisis, all treatment performed was the prolonging of the neonate’s physical suffering and the emotional pain of its parent/s. Possible alternative methods of intervention to those practiced routinely will still harbor risks and related barriers to success. (4)
With this in mind, researchers are exploring an alternative physiological approach to maintaining underdeveloped human beings by better mimicking the uterine conditions to effectively prolong gestation. This encompasses a maintenance system closer to an AW, promoting continuing growth as if the neonate had never been born, as opposed to infant incubators supporting preterms with bodily functions they cannot perform adequately for themselves.
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To be continued with the biobag in the next part of can Artificial womb replace a mother’s womb?