Ang isang pag-aaral ay matagumpay na nakabuo at sumubok ng panlabas na sisidlan na parang sinapupunan sa mga sanggol na tupa, na nagbubunga ng pag-asa para sa mga sanggol na wala pa sa panahon sa hinaharap.
An artipisyal sinapupunan idinisenyo at binuo na may layuning suportahan ang mga marupok na sanggol na wala pa sa panahon ay matagumpay na naipakita sa unang pagkakataon sa mga hayop (baby sheep dito). Ang pag-aaral na ito ay inilathala sa Kalikasan 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 kalat sa buong mundo.
Ginagaya ang sinapupunan
Ang pag-aaral na pinangunahan ni Propesor Alan Flake, isang surgeon at direktor ng Center for Fetal Research sa Center for Fetal Diagnosis and Treatment sa Children's Hospital of Philadelphia, USA ay nagpapakita na ang mga tupa na ipinanganak na preterm (sa katumbas ng 23 o 24 na linggong pagbubuntis sanggol na tao) ay matagumpay na napanatiling buhay at lumilitaw din na umuunlad nang normal habang lumulutang sa loob ng isang transparent, parang sinapupunan lalagyan ng suporta o sisidlan, na tinatawag na "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 malusog grown sheep.
Premature births: isang malaking pasanin
Ito ay hinulaan na 15 milyong mga sanggol na tao ay ipinanganak na preterm (bago ang 37 linggo) bawat taon sa buong mundo at ang bilang na ito ay tumataas lamang. Ang rate ng preterm birth ay mula 5% hanggang 18% ng mga sanggol na ipinanganak sa 184 na bansa sa buong mundo. Ang mga komplikasyon na lumitaw dahil sa preterm na kapanganakan ay isang nangungunang sanhi ng kamatayan sa mga batang wala pang 5 taong gulang.
Karamihan sa mga pagkamatay ng sanggol ay nauugnay sa prematurity kahit na pagkatapos ng makabuluhang pagpapabuti sa mga kasanayan sa pangangalaga sa bagong panganak. At kahit na ang mga marupok na sanggol na nabubuhay sa 23-23 na linggo (30-50 porsiyento ay nabubuhay), kailangan pa rin nilang magdusa mula sa mababang kalidad ng buhay, nahaharap sa mga permanenteng problema sa kalusugan at kahit na panghabambuhay na kapansanan sa maraming kaso. Gayundin, ang pag-access sa mataas na antas ng pangangalaga ay nakakaapekto sa mga resulta nang iba sa bawat kaso. Ang mga sitwasyong ito ay naglalagay din ng pinansiyal at emosyonal na pasanin sa mga magulang pati na rin sa sektor ng pangangalagang pangkalusugan.
Ngayon tupa, susunod ay tao?
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.
Ito ay isang kaakit-akit, hindi pangkaraniwang agham
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.
***
{Maaari mong basahin ang orihinal na papel ng pananaliksik sa pamamagitan ng pag-click sa link ng DOI na ibinigay sa ibaba sa listahan ng (mga) binanggit na pinagmulan}
Pinagmulan (s)
Partridge EA et al. 2017. Isang extra-uterine system para pisyolohikal na suportahan ang sobrang napaaga na tupa. Nature Communications. 8(15112) http://doi.org/10.1038/ncomms15112.
