Report of an Experiment With a Fetal Ex-Utero Support System in Piglets

• Published in: Curēus (Palo Alto, CA) CA), 2023-04, Vol.15 (4), p.e38223-e38223
• Main Authors: Abrao Trad, Ayssa T, Buddington, Randal, Enninga, Elizabeth, Duncan, Jose, Schenone, Claudio V, Mari, Giancarlo, Buddington, Karyl, Schenone, Mauro
• Format: Article
• Language: English
• Subjects: Amniotic fluid; Catheters; Experiments; Fetuses; Gestational age; Healthcare Technology; Hogs; Intubation; Lungs; Newborn babies; Obstetrics/Gynecology; Pediatrics; Physiology; Premature babies; Surgical apparatus & instruments; Umbilical cord; Uterus; Veins & arteries
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.38223

Extreme prematurity remains one of the leading causes of neonatal death. An ex-utero treatment strategy that allows the fetus to develop beyond this period until capable of tolerating the transition to post-natal physiology would significantly impact the quality of care offered for this pre-viable patient population. In this study, we report our experience with an ex-utero support system for fetal pigs with the goal of support and survival for eight hours. Our experiment included two pigs at a gestational age equivalent to a 32-week human fetus. Following ultrasound assessment and delivery via hysterotomy, the fetuses were transferred to a 40 L glass aquarium filled with warmed lactated Ringer's solution and connected to an arteriovenous (AV) circuit that included a centrifugal pump and a pediatric oxygenator. Fetus 1 was successfully cannulated and survived for seven hours (expected maximum duration of eight hours). Fetus 2 died shortly after hysterotomy, secondary to failure at the cannulation stage. Our results suggest that ex-utero support of the premature fetal pig is feasible, contributing to a scarce body of evidence. However, further studies are needed before effectively translating an artificial placenta system into the clinical arena.