[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-43495-en":3,"doc-seo-43495-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},43495,13056703020460,"Valentina","https://ap-avatar.wpscdn.com/avatar/be000253dac470eee5d?_k=1778207105932848923",8,"Research & Report","An extra-uterine system to physiologically support the extreme premature lamb","Extreme prematurity is a leading driver of neonatal mortality and morbidity, driven by immature organs and iatrogenic injury, while prior extracorporeal strategies to extend gestation have shown limited effectiveness. A new extra-uterine system is reported using a pumpless oxygenator circuit linked to fetal lambs via an umbilical cord interface within a closed, amniotic-fluid–like environment. Developmentally equivalent lambs can be supported for up to four weeks with stable hemodynamics, normal blood gases and oxygenation, patent fetal circulation, and—with nutritional support—normal growth, lung maturation, and brain development including myelination.","ARTICLE  \nReceived 25 Apr 2016 | Accepted 2 Mar 2017 | Published 25 Apr 2017  DOI: 10.1038/ncomms15112  OPEN  \nAn extra-uterine system to physiologically support the extreme premature lamb  \nEmily A. Partridge1,*, Marcus G. Davey1,*, Matthew A. Hornick1, Patrick E. McGovern1, Ali Y. Mejaddam1, Jesse D. Vrecenak1, Carmen Mesas-Burgos1, Aliza Olive1, Robert C. Caskey1, Theodore R. Weiland1, Jiancheng Han1, Alexander J. Schupper1, James T. Connelly1, Kevin C. Dysart2, Jack Rychik3, Holly L. Hedrick1, William H. Peranteau1 & Alan W. Flake1  \nIn the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed ‘amniotic fluid’ circuit that closely reproduces the environment of the womb. We show that fetal lambs that are developmentally equivalent to the extreme premature human infant can be physiologically supported in this extra-uterine device for up to 4 weeks. Lambs on support maintain stable haemodynamics, have normal blood gas and oxygenation parameters and maintain patency of the fetal circulation. With appropriate nutritional support, lambs on the system demonstrate normal somatic growth, lung maturation and brain growth and myelination.  \n1 Center for Fetal Research, Department of Surgery, The Children’s Hospital of Philadelphia Research Institute, Room 1116B, 3615 Civic Center Boulevard, Philadelphia, Pennsylvania 19104, USA. 2 Division of Neonatology, Department of Pediatrics, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, Pennsylvania 19104, USA. 3 Division of Cardiology, Department of Pediatrics, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, Pennsylvania 19104, USA. *These authors contributed equally to this work. Correspondence and requests for materials should be addressed to A. W. F. (email: fl[ake@email.chop.edu](ake@email.chop.edu)) .  \nNATURE COMMUNICATIONS|8:15112 | DOI: 10 .1038/ncomms15112| [www.nature.com/naturecommunications](www.nature.com/naturecommunications) 1  \ninfanmatutritdey1a–t3hs aAnddvaonences-half of cerebin neonatalral palsyintensiveattribucaretedhatvoe  \nn the United States, extreme prematurity is the leading cause  \nof infant morbidity and mortality, with over one-third of all  \nimproved survival and pushed the limits of viability to 22 to 23 weeks of gestation. 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 1,3 . In fact, with earlier limits of viability, there are actually more total patients with severe complications of prematurity than there were a decade ago4. 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. This condition, known as bronchopulmonary dysplasia, is now understood to be related to an arrest in lung development secondary to premature transition from liquid to gas ventilation, explaining why even minimally invasive modes of neonatal ventilation have not reduced the incidence of bronchopulmonary dysplasia5. There is clearly an urgent need for a more physiologic approach to support the extreme premature infant.  \nThe concept of extracorporeal support of the fetus is appealing due to the analogy with innate fetal physiology, in which extracorporeal gas exchange is maintained by the placenta. However, the development of an ‘artificial placenta’ has been the subject of investigation for over 50 years6,7, with only limited success. The primary obstacles have been progressiv","cbCaijYwhfhGuNsY","https://ap.wps.com/l/cbCaijYwhfhGuNsY","pdf",2397022,4,1,15,"English","en",105,"# Introduction\n## Background and clinical need\n## Artificial placenta and key obstacles\n## System design overview\n# Results\n## Pilot studies and design modifications","[{\"question\":\"What problem does the study address in extreme prematurity?\",\"answer\":\"Extreme prematurity leads to high neonatal mortality and morbidity because of organ immaturity and injury. The work targets the urgent need for more physiologic support for extremely preterm infants.\"},{\"question\":\"How does the new device support fetal lambs outside the uterus?\",\"answer\":\"The system uses a pumpless oxygenator circuit connected to the fetus through an umbilical cord interface inside a closed amniotic-fluid–like environment, aiming to reproduce womb conditions while maintaining fetal circulation.\"},{\"question\":\"What outcomes were observed during support in the fetal lamb model?\",\"answer\":\"Supported lambs maintained stable hemodynamics, normal blood gas and oxygenation parameters, and patency of the fetal circulation. With appropriate nutrition, lambs showed normal somatic growth, lung maturation, and brain growth with myelination.\"}]",1783381829,38,{"code":4,"msg":31,"data":32},"ok",{"site_id":25,"language":24,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":28},"an-extra-uterine-system-to-physiologically-support-the-extreme-premature-lamb","",{"@graph":36,"@context":85},[37,53,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/research-report/",3,{"item":52,"name":13,"@type":43,"position":20},"https://docshare.wps.com/document/an-extra-uterine-system-to-physiologically-support-the-extreme-premature-lamb/43495/",{"url":52,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":24,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":41,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-16","2026-07-06",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"What problem does the study address in extreme prematurity?","Question",{"text":75,"@type":76},"Extreme prematurity leads to high neonatal mortality and morbidity because of organ immaturity and injury. The work targets the urgent need for more physiologic support for extremely preterm infants.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"How does the new device support fetal lambs outside the uterus?",{"text":80,"@type":76},"The system uses a pumpless oxygenator circuit connected to the fetus through an umbilical cord interface inside a closed amniotic-fluid–like environment, aiming to reproduce womb conditions while maintaining fetal circulation.",{"name":82,"@type":73,"acceptedAnswer":83},"What outcomes were observed during support in the fetal lamb model?",{"text":84,"@type":76},"Supported lambs maintained stable hemodynamics, normal blood gas and oxygenation parameters, and patency of the fetal circulation. With appropriate nutrition, lambs showed normal somatic growth, lung maturation, and brain growth with myelination.","https://schema.org",{"og:url":52,"og:type":87,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":89,"canonical":52},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":92},[93,97,101,105,110,115,120,123,128,131,135],{"id":21,"doc_module":4,"doc_module_name":46,"category_name":94,"show_sort_weight":95,"slug":96},"Story & Novel",90,"story-novel",{"id":47,"doc_module":4,"doc_module_name":46,"category_name":98,"show_sort_weight":99,"slug":100},"Literature",80,"literature",{"id":20,"doc_module":4,"doc_module_name":46,"category_name":102,"show_sort_weight":103,"slug":104},"Exam",70,"exam",{"id":106,"doc_module":4,"doc_module_name":46,"category_name":107,"show_sort_weight":108,"slug":109},5,"Comic",60,"comic",{"id":111,"doc_module":4,"doc_module_name":46,"category_name":112,"show_sort_weight":113,"slug":114},6,"Technology",50,"technology",{"id":116,"doc_module":4,"doc_module_name":46,"category_name":117,"show_sort_weight":118,"slug":119},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":46,"category_name":12,"show_sort_weight":121,"slug":122},30,"research-report",{"id":124,"doc_module":4,"doc_module_name":46,"category_name":125,"show_sort_weight":126,"slug":127},9,"Religion & Spirituality",20,"religion-spirituality",{"id":126,"doc_module":4,"doc_module_name":46,"category_name":129,"show_sort_weight":126,"slug":130},"World Cup","world-cup",{"id":132,"doc_module":4,"doc_module_name":46,"category_name":133,"show_sort_weight":132,"slug":134},10,"Lifestyle","lifestyle",{"id":136,"doc_module":4,"doc_module_name":46,"category_name":137,"show_sort_weight":106,"slug":138},19,"General","general"]