Premature babies can be treated well in the NICU, but over the past ten years we have not seen much improvement in healthcare outcomes. Myrthe van der Ven and her team at the Eindhoven University of Technology felt that this had to change. “Of course you want to increase the survival rate, but at the same time you also want to prevent the chance of disabilities later in life,” Myrthe explains. “When the baby is born after 24 weeks of pregnancy, the organs are not yet fully developed. But as soon as the child is born, those organs actually have to work. Take the lungs, for example. At that moment, they cannot yet absorb enough oxygen, which often requires ventilation. Because of those tubes and the pressure of the air that is pressed into them, the children can suffer from this for the rest of their lives.”
Simulating a natural situation
The idea is to approach this in a physiological way. “We start from the situation in the womb and we want to imitate that environment as closely as possible. In the womb, the baby is in the amniotic fluid and receives nutrients and oxygen via the placenta. We want to keep a piece of the baby’s umbilical cord so that we can connect it to an artificial placenta. After birth, we can no longer use the mother’s placenta. If we can imitate that womb environment, the baby can continue to develop for a few more weeks. That can easily increase the chance of survival from 60% to 90%, with less chance of health complications later in life.”
Technological acceptance
Although the technology is not new, the application is. “A gynaecologist from our team saw an initial version of a similar technology at a conference years ago. The seed for AquaWomb was planted then and in 2018 we continued with that idea. They are already working on it in America and Australia, so we cannot lag behind in Europe. That is why we are also developing this within a European project. The biggest challenge is therefore not in the technology, but in its acceptance. You can create a technological feat, but that does not guarantee that it will actually reach the patient. That is why we involved parents with premature babies in the process from the start, as well as the healthcare professionals who will ultimately use it. After all, it has to fit their needs, also when it comes to parent-child bonding. We do not want to underexpose that aspect.”
Practical challenge
AquaWomb received a TTT MedTech voucher. “On the one hand, we are mapping the ecosystem, and on the other hand, we are investigating a practical challenge. We need to find a way to get the baby from the real womb into the artificial womb. We have developed a procedure for this with Industrial Design from TU/e, in which we keep the baby under water. We want to record this procedure with video material so that we can test it with doctors. That way, we also know for sure that they fully support it and can work with it.”
Million dollar babies
The impact that the artificial womb can have on the health of premature babies translates into economic impact. “In America, they call children who are born far too early ‘million dollar babies’. When a child is born healthy at 40 weeks, it costs $6,000 for the first 6 months. But if a child is born at 24 weeks, it costs $600,000. That is a huge difference. And then we haven’t even mentioned the healthcare costs that they will most likely need later in life. Because that is also what it is all about: that these children get a better quality of life. In about ten years, I hope that the first babies can already be treated in this way, whether or not in a study context. Ultimately, those extremely vulnerable children and their parents deserve to be helped a step further. I want them to have a better chance for the rest of their lives.”