HCR.20.052 – Towards an artificial womb for extremely premature born infants

Route: Health care research, sickness prevention and treatment

Cluster question: 091 Pregnancy, childbirth, and menopause - can we make them better for women?

After birth, each infant faces a physiologic transition from maternal-placental life-support to (self-supportive) extra-uterine life. For prematurely born infants, this transition comes too early, thereby placing an unfeasible demand on their immature vital organs. Hence extremely preterm born infants often face lifelong serious health problems and social consequences. In recent years, premature lambs have been successfully sustained in a liquid-based environment, allowing them to develop similarly as in utero instead of being born during an extreme premature period. These results are promising for human application. However, before this technique can be safely applied in a clinical setting, first physiological, developmental, ethical, legal, societal issues and associated costs have to be studied. In this interdisciplinary project, we will study the effects of development in a liquid-based incubator on various vital organs and systemic functions. We will combine clinical knowledge and measurements from current clinical practice with simulation models, animal studies and ultimately a first-in-human study. In addition, we will study legal and socio-ethical aspects of this perinatal life-support system. The Dutch perinatal tertiary centers have a large track record in physiological research, fetal and neonatal therapy, perinatal life support in fetal sheep, monitoring and biosensing, and socio-ethical and legal aspects. Moreover, the technical universities are, together with industrial partners, specialized in developing measurement methods, analytics and signal processing, clinical decision support models, and physical and physiological simulation models. This project aims at contributing to a more physiological approach for the treatment of imminent extreme preterm born infants. It is expected that, similar to the fetal lamb studies, a perinatal life-support system based on a liquid environment, with preservation of fetal (cardiovascular and pulmonary) physiology, will allow physiological growth and development during this vulnerable period. Ultimately, these infants should have better health outcome than prematurely born infants with conventional care.
Persons involved: Amsterdam UMC: prof.dr. A.H.L.C. van Kaam (Neonatal Pulmonology), dr. M.A. Oudijk (Perinatology & Preterm Birth), dr. W. Onland (Neonatal Pulmonology), dr. C. Ris (Molecular Obstetrics & Molecular Endocrinology), drs. M.H.M. van Stekelenburg (Theology & Ethics), prof. C.J.M. Verhoeven (Midwifery Science), drs. M. Zuijderland (Bioethics & Technology Philosophy); Radboud UMC (RUMC): dr. W.P. de Boode (Neonatal Haemodynamics & Animal Models), dr. J. van Drongelen (Perinatology & Biomedical Health Science), dr. A.F.J. van Heijst (Neonatology & ECMO), dr. R.R. Scholten (Perinatology & Cardiovascular Risk); Erasmus MC (EMC): dr. A.J. Eggink (Perinatology & Foetal Therapy), dr. H. Ismaili M’hamdi (Medical Ethics), prof.dr. I.K.M. Reiss (Neonatology), dr. M.J. Vermeulen (Neonatology); UMC Groningen (UMCG): prof.dr. P.P. van den Berg (Perinatology & Foetal Medicine), prof. J.J.H.M. Erwich (Perinatology & Placental development); Leiden UMC (LUMC): mr. E.J. Oldekamp (Health Law), prof.dr. A.B. te Pas (Neonatology, Perinatal Transition & Neonatal resuscitation), dr. F. Slaghekke (Perinatology & Foetal Therapy), dr. E.J.T. Verweij (Foetal Therapy & Medical Ethics); UMC Maastricht (MUMC): prof.dr. B.W.W. Kramer (Neonatology, Pulmonary and Immune System Development, Animal Models), prof.dr. M.E.A. Spaanderman (Perinatology & Vascular Damage); UMC Utrecht (UMCU): prof.dr. M.J.N.L. Benders (Neonatology & Neuroprotection), prof K.W.M. Bloemenkamp (Perinatology & Maternal Health), dr. J.B. Derks (Perinatology & Antenatal Neuroprotection), dr. F. Groenendaal (Neonatology & Neuroprotection), dr. A.T. Lely (Perinatology & Nephrology), dr. C.H.A. Nijboer (Neuroprotection & Neuroregeneration); Eindhoven University of Technology (TU/e): dr. H.K.G. Andersen (Industrial Design of Embedded Systems & Perinatal Simulation), dr. P. Andriessen (Neonatology & Monitoring), prof.dr.ir.ing. R.N.A. Bekkers (Innovation & Society), prof.dr.ir. J.W.M. Bergmans (Signal Processing, Pathophysiological Modelling & Clinical Decision Support), dr.ir. F.L.M. Delbressine (Industrial Design of Embedded Systems & Perinatal Simulation), prof.dr.ir. L.M.G. Feijs (Industrial Design of Embedded Systems), dr. L.E. Frank (Reproductive Ethics & Moral Psychology), dr.ir. M.B. van der Hout (Medical engineering, Monitoring & Simulation), prof.dr. E.M. Kingma (Philosophical Bioethics), dr. D. Kommers (Preterm birth & parent-infant bonding), dr. J.O.E.H. van Laar (Perinatology & Fetal Cardiovascular Monitoring), prof.dr.ir. M. Mischi (Signal Processing, Pathophysiological Modelling & Clinical Decision Support), dr. H.J. Niemarkt (Neonatology & Surfactant Therapy), prof.dr. S.G. Oei (Perinatology, Monitoring & Simulation), dr. M.C.M. Rutten (Cardiovascular Biomechanics & Clinical Decision Support Modelling), dr. M. van der Ven (Technical Medicine, Monitoring & Simulation), dr.ir. R. Vullings (Signal Processing & Non-invasive Foetal ECG), dr. D. van der Woude (Perinatology & Non-invasive Foetal ECG); University of Twente: Prof.dr.ir. J. Arens (Bioengineering & Artificial Lung Development), Isala Zwolle: Dr. J. van Eyck (Perinatology), Delft University of Technology (TUD): prof.dr. J. Dankelman (Biomechanical Engineering, Minimal Invasive Surgery & Interventional Techniques).

Keywords

fetal development, fetal physiology, liquid-based incubator, mathematical modeling, Monitoring, perinatal life support, premature infants

Other organisations

Amsterdam UMC, Eindhoven University of Technology (TU/e), Erasmus Medical Center (EMC), Leiden Universitair Medisch Centrum (LUMC), Radboud Medical Center (RUMC), Technische Universiteit Delft (TUD), UMC Maastricht (MUMC), UMC Utrecht (UMCU): Eindhoven University of Technology (TU, Universitair Medisch Centrum Groningen (UMCG), Universiteit Twente (UT)

Submitter

Organisation Eindhoven University of Technology (TU/e)
Name Prof.dr.ir. F.N. (Frans) van de Vosse
E-mail f.n.v.d.vosse@tue.nl