Artificial Ex Utero Systems to Treat Severe Periviable Fetal Growth Restriction—A Possible Future Indication?

Fetal growth restriction, or intrauterine growth restriction, is a common gestational condition characterized by reduced intrauterine growth. However, severe periviable fetal growth restriction is still associated with elevated perinatal mortality and morbidity. The current literature advises delivery once it is deemed that fetal compromise is evident. As uteroplacental insufficiency is the most common etiology of this condition, we hypothesize that the use of artificial ex utero systems to provide adequate nutrition and recreate the uterine environment may be a viable treatment option in this situation, even with the possibility of treating severe fetal growth restriction and prevent sequelae. There are promising experimental studies in sheep models investigating the artificial ex utero system for potential prenatal conditions, but future additional investigation is needed before translating to clinical trials in humans.