The following article originally appeared in the Fall 2017 issue of the MCFL News magazine, a perk of membership mailed out quarterly to all members.
New tools and technologies are tricky things. While pro-lifers acknowledge the good of new life-saving technologies, we become uneasy with the trade-offs that technology seems to impose on our common humanity. What should we make of scientific advances that may potentially supplement maternal gestation with machines? These potential advances are particularly relevant in light of the presentation by neonatologist Dr. Martin McCaffrey at the MCFL Convention in April, concerning the crisis of premature birth and its association with abortion.
On April 25, Nature Communications Today NCT published a report by scientists at the Children’s Hospital of Philadelphia Research Institute on the development of an artificial womb that physiologically supports the extreme premature lamb. Fetal lambs, who are developmentally equivalent to extremely premature human infants, were supported in the device, which connected the lambs' umbilical cord to machinery, enabling fluid gas exchange to their developing lungs for up to four weeks. Could this advance one day lead to an effective treatment for premature human infants?
Dr. McCaffrey had highlighted the devastating problems associated with the rise of preterm birth. In 2015, almost ten percent of all babies born in the United States were preterm, a percentage that has risen twenty percent in the last 20 years. Premature birth is defined as birth prior to 37 weeks with very preterm birth defined as babies born at less than 32 weeks. In 2015, 63,000 births were very preterm births. McCaffrey had remarked, “These constitute 1.6% of all births and are associated with the highest risks for death and morbidity: respiratory distress, brain bleeding, blindness, hearing loss, mental retardation, and cerebral palsy. The annual cost of care for very preterm babies, just for their first year of life, is $26 billion.”
The team at Children's Hospital said that advances in neonatal intensive care have improved survival and improved the limits of viability to 22 to 23 weeks of gestation, just the age that Dr. McCaffrey noted had the lowest probability of survival outside the womb. The NCT report continued, “However, survival has been achieved with high associated rates of chronic lung disease and other complications of organ immaturity, particularly in infants born before 28 weeks. In fact, with earlier limits of viability, there are actually more total patients with severe complications of prematurity than there were a decade ago. Respiratory failure represents the most common and challenging problem, as gas exchange in critically preterm neonates is impaired by structural and functional immaturity of the lungs.”
“The development of an ‘artificial placenta’ has been the subject of investigation for over 50 years, with only limited success,” said the research team. “The primary obstacles have been progressive circulatory failure due to imbalance imposed on the fetal heart, the use of open fluid incubators resulting in contamination and fetal sepsis, and problems related to umbilical vascular access resulting in vascular spasm. Here we demonstrate that extreme premature fetal lambs can be consistently supported for up to 4 weeks without apparent physiologic derangement or organ failure. These results are superior to all previous attempts at extracorporeal support of the extreme premature fetus in both duration and physiologic well-being.”
Researchers said they were in a preliminary phase of development and not in a position to offer the therapy, since possible human trials are coming three years in the future. “We have been gratified that in a few presentations to lay people and multiple presentations to neonatologists and maternal fetal medicine groups, there have been few objections raised, and in general, the response has been overwhelmingly supportive,” they said. “The clinical device will resemble a standard nursery incubator. While the parent cannot touch the fetus, the unit will have 3D ultrasound capability, as well as a real time dark-field camera (because light will be very limited in the device) to allow the parents to visualize the fetus on a continuous basis if they wish. In addition, we plan to play maternal abdominal and heart sounds and allow the parents to speak to the fetus, etc. within the device if they wish, so there will at least be some connection.”