DEVELOPMENT OF AN ARTIFICIAL PLACENTA

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The aim of our study was to newly develop an extrauterine incubation system closely resembled that of a fetus in utero in both the extracorporeal and intracorporeal environments, in order to incubate and extremely premature baby or a fetus having a disease which should be treated in utero. The extrauterine incubation system consisted of an artificial womb containing artificial amniotic fluid and a cpmplete artificial placental system with a membrane oxygenator which was used for A-V ECMO.Materials we used were goat fetuses. After long-term extrauterine incubation, goat fetuses were tried to remove from the incubator and stimulated to initiate lung respiration. At the first, we examined the feasibility of long-term extrauterine incubation of relatively matured (125-130 days of gestation) goat fetuses, and at the second, premature (90-100 days of gestation) goat fetuses. In premature goat fetuses as well as relatively matured ones, long-term extrauterine incubation without cardiac failure could be achieved by administration of diazepam and pancronium bromide into the blood circuit to supress fetal movement an swallowing. Because they could be implicated in fetal deterioration during extrauterine fetal incubation. After removal from the incubator, these animals could survive for more than 1 week, if only with ventilator support. In consequence, we could prove that long-term umbilical A-V ECMO was in itself not harmful to fetal survival. But the administered pancronium bromide might have caused fetal neuromuscular disturbances that could prevent spontaneous breathing. Before this system can be applied for humans, numerous problems such as water homeostasis and nutrition maintenance as well as the muscle weakness due to long term immobilization must be resolved.