نجحت إحدى الدراسات في تطوير واختبار وعاء خارجي يشبه الرحم على صغار الأغنام ، مما يولد الأمل للأطفال المبتسرين في المستقبل
An مصطنع رحم تم تصميمه وتطويره بهدف دعم الأطفال الخدّج الهشّين وقد تم عرضه بنجاح لأول مرة على الإطلاق في الحيوانات (صغار الأغنام هنا). نشرت هذه الدراسة في الطبيعة Communications is a major scientific breakthrough for the year 2017 and has generated immense hope for preterm newborns. This is the kind of study that immediately strikes a chord with the general public as it has a huge potential to affect the lives of millions of preterm babies في جميع أنحاء العالم.
تقليد الرحم
أظهرت الدراسة التي قادها البروفيسور آلان فليك ، وهو جراح ومدير مركز أبحاث الجنين في مركز تشخيص وعلاج الجنين في مستشفى الأطفال في فيلادلفيا بالولايات المتحدة الأمريكية ، أن الحملان تلد قبل الأوان (بما يعادل 23 أو 24 أسبوعًا من الحمل. رضيع بشري) نجح في البقاء على قيد الحياة ويبدو أيضًا أنه يتطور بشكل طبيعي أثناء الطفو داخل شفاف ، يشبه الرحم حاوية أو وعاء دعم يسمى "Biobag".
This current novel system mimics life in the uterus as closely as possible by utilizing knowledge from previous neonatal research. It uses a distinctive fluid-filled plastic container or vessel attached to other custom-designed machines which provide the necessary physiological support. The fetal lambs grows in a sealed, temperature-controlled, sterile environment insulated from any variations (temperature, pressure or light) and hazardous infections, while breathing amniotic fluid as they normally would do in the womb. The baby’s heart pumps blood via the umbilical cord into the system’s low-resistance external oxygenator that very intelligently substitutes for the mother’s placenta in exchanging oxygen and carbon dioxide. This is extremely necessary since at this gestation period baby’s lungs are not developed yet to breathe in oxygen from the atmosphere. Different electronic monitors continuously measure their vital signs. For the system to be successful, its inflow and outflow apparatus have been continuously designed and redesigned at regular intervals. The lambs successfully continued to grow in the Biobag for full four weeks (670 hr over 28 days) after their birth and showed normal breathing, swallowing, eye movement, activity signs, sprouted wool and a very normal growth and organ maturation. Researchers call this as an “awe-inspiring sight” but nevertheless, they state that their system needs continuous evaluation and refinement.
The researchers did not try to extend viability to an earlier period than the current mark of 23 weeks because of several limitations which increase risks, including size, physiological functioning would impose unacceptably high risks. Most of the lambs from the study were euthanized before they reached full term for further evaluation; however one is now a صحي grown sheep.
الولادة المبكرة عبء كبير
من المتوقع أن 15 مليون طفل يولدون قبل الأوان (قبل 37 أسبوعًا) كل عام في جميع أنحاء العالم وهذا العدد في ازدياد فقط. يتراوح معدل الولادة المبكرة بين 5٪ و 18٪ من الأطفال المولودين في 184 دولة حول العالم. المضاعفات التي تنشأ بسبب الولادة المبكرة هي سبب رئيسي للوفاة بين الأطفال دون سن الخامسة.
تُعزى غالبية وفيات الرضع إلى الخداج حتى بعد التحسن الملحوظ في ممارسات رعاية الأطفال حديثي الولادة. وعلى الرغم من أن الأطفال الرضّع الهشّين القادرين على البقاء على قيد الحياة في الفترة من 23 إلى 23 أسبوعًا (30-50 بالمائة يفعلون ذلك) ، لا يزالون يعانون من تدني نوعية الحياة ، ويواجهون مشاكل صحية دائمة وحتى إعاقة مدى الحياة في كثير من الحالات. أيضًا ، يؤثر الوصول إلى رعاية عالية المستوى على النتائج بشكل مختلف في كل حالة. تضع هذه السيناريوهات عبئًا ماليًا وعاطفيًا على الآباء وكذلك على قطاع الرعاية الصحية.
الآن الغنم ، بعد البشر؟
This study tests and monitors the effects on fetal lambs and it is already known that prenatal lung development in sheep is very similar to humans. Though the sheep brains develop at a somewhat different pace than humans. The current system will need to downsized for human infants, who are around one-third the size of the infant lambs that were used in the study. If it is similarly successful for human babies in the coming 1-2 decades, there is an astonishing likelihood that extremely premature infants will continue to develop in chambers or vessels that are filled with womb like amniotic fluid, rather than relying on incubators supported by ventilators and won’t have to suffer from multiple invasive procedures.
Human testing which can be carried forward from this study is still, realistically speaking, a couple of decades away, but this study definitely predicts possible similar success on human infants. The main aim is to cross the threshold of 28 weeks for human premature babies, which then reduces any severe outcomes on life. Such an extra-uterine system/artificial womb if developed for growth and organ maturation for only just a few weeks can dramatically improve outcomes for premature human babies.
هذا علم جذاب وخارق للعادة
Looking at this study, we could start imagining a world where babies can grow in an artificially simulated womb thus eliminating possible health risks of pregnancy which affect the mother as well as the unborn baby. However, we cannot get carried away with these thoughts, because removing the most important element – “the creator and nurturer of life” – the mother from the entire process would really make growth of babies (from 0 till 9 months) a stuff of science fiction with the entire early development happening literally on a machine. The idea which researchers have propagated is not to “entirely eliminate” mothers but rather provide a technology to reduce and/or prevent mortality and morbidity caused by preterm births.
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{يمكنك قراءة ورقة البحث الأصلية عن طريق النقر فوق ارتباط DOI الوارد أدناه في قائمة المصدر (المصادر) المذكورة}
المصدر (ق)
بارتريدج EA وآخرون. 2017. نظام خارج الرحم لدعم الحمل الخديج من الناحية الفسيولوجية. طبيعة الاتصالات. 8 (15112) http://doi.org/10.1038/ncomms15112.
