Outcomes for extremely low gestational age newborns (ELGANs), defined as <28 weeks estimated gestational age (EGA), remain disproportionately poor. A radical paradigm shift in the treatment of prematurity is to recreate the fetal environment with extracorporeal support and provide an environment for organ maturation using an extracorporeal VV-ECLS artificial placenta (AP) or an AV-ECLS artificial womb (AW). In this article, we will review clinical indications, current approaches in development, ongoing challenges, remaining milestones and ethical considerations prior to clinical translation.

中文翻译：

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ECLS 的新前沿：早产儿人工胎盘和人工子宫

极低胎龄新生儿 (ELGAN)（定义为估计胎龄 (EGA) 小于 28 周）的预后仍然非常差。早产儿治疗的根本性范式转变是通过体外支持重建胎儿环境，并使用体外 VV-ECLS 人工胎盘 (AP) 或 AV-ECLS 人工子宫 (AW) 提供器官成熟的环境。在本文中，我们将回顾临床适应症、当前的开发方法、持续的挑战、剩余的里程碑以及临床转化之前的伦理考虑。