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Fetus Scan

Pregnancy ultrasound - Schedule and importance of dating, growth, anomaly scan
Which | When | Why
By
Dr. Mayank Gupta
M.B.B.S., M.D Radiodiagnosis (FMF , UK Certified) Ex Sr. Residency BVP-Pune , Rajiv Gandhi Cancer Hospital, New Delhi Ex Associate Consultant, Sir Ganga Ram Hospital, Delhi Society of Foetal Medicine IRIA, IMA, International Society of Ultrasound in Obstetrics and Gynecology (ISUOG)
Words of motivation

As a radiologist, every pregnancy scan tells a beautiful story of new life unfolding. When an expectant mother gently rests her hands on her belly, we see more than just images on a screen—we witness a powerful bond forming between mother and child. Each heartbeat, each movement captured during the ultrasound reflects the miracle of growth happening inside her womb. Pregnancy is a remarkable nine-month journey, where every stage brings new developments. From the first tiny heartbeat to the well-formed features of the baby, our role is to carefully monitor this progress and ensure everything is developing healthily. With advanced imaging and precise diagnostics, we help mothers feel confident and reassured at every step. Our commitment is to provide accurate, compassionate care so that every mother can enjoy this phase without worry. Because when it comes to nurturing new life, nothing matters more than trust, expertise, and the right medical support.

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Pregnancy is a nine-month journey during which a baby gradually develops from a few cells into a fully formed human being. Regular ultrasound scans play a vital role in monitoring this growth and ensuring the health of both mother and baby. Key scans such as the dating scan, anomaly scan, cardiac scan, and growth scan are performed at specific stages of pregnancy to assess development, detect abnormalities, and track overall well-being. When done on time, these specialized ultrasounds provide essential medical information to support safe and healthy motherhood.

Pregnancy is divided into three trimesters, each lasting three months. During this time, the baby develops gradually, making regular monitoring essential. As the mother’s body undergoes many changes, timely doctor visits, proper nutrition, medications, and scheduled ultrasound scans help ensure a safe, smooth, and healthy pregnancy journey.

There are some ultrasounds scan that needs to be performed during one's period of pregnancy. We shall have a closer look at the most significant and necessary ultrasounds offered in one's pregnancy from the first to third trimesters. Here is a quick summary of the pregnancy ultrasound scan.

 
TrimesterWeekScan namePurpose
1st6 to 8

Early pregnancy or dating scan

Confirm the pregnancy, its position, and estimate the baby’s age.
11 to 13

NT / ND scan

Measures Nuchal Translucency, check for nasal bone, examine the spinal column. Uterine artery doppler is also checked.
2nd18 to 20

Anomaly or TIFFA scan

Check anatomic structures and find out a defect in the baby and placenta. Most important pregnancy scan.
24 to 26

Cardiac scan / Fetal echocardiography

Evaluate structural and functional integrity of fetal heart.
3rd28 to 32

Pregnancy welfare and growth scan

Check the progress of the baby’s growth and status of liquor (fluid around the baby).
28 to 32

Obstetric doppler scan (Optional)

Measures the blood flow through the umbilical cord to the different internal organs of the developing baby’s body
36 to 40

Growth scan. Obstetric doppler scan (If needed)

Check baby’s growth, position, amount of liquor, and blood flow to the baby.

First Trimester Ultrasound

1st trimester

Pregnancy is a beautiful journey in which a baby gradually develops day by day inside the womb. During the early weeks, the mother plays a vital role in nurturing both herself and the growing life within her. By 6 to 8 weeks of pregnancy, the developing cells form a small body mass, and important physical changes become visible.

Two essential ultrasound scans are recommended during the first trimester. The first is the dating scan (6–8 weeks), which confirms pregnancy, detects the baby’s heartbeat, determines gestational age, and checks for abnormalities such as internal bleeding or ectopic pregnancy. It also helps identify twin or multiple pregnancies. This scan is usually performed using a transvaginal approach for clearer imaging, though an abdominal method may also be used.

The second important scan is the Nuchal Translucency (NT) scan, done between 11 weeks and 13 weeks 6 days. This scan measures the fluid at the back of the baby’s neck and checks spinal development and the presence of the nasal bone. It is commonly combined with a double marker blood test to assess the risk of chromosomal abnormalities.

For twin pregnancies, the NT scan helps determine the type of twins and guides further care. Additional measurements such as uterine artery Doppler assess the risk of high blood pressure and growth issues, while cervical length evaluation helps identify the risk of preterm birth.

What is anomaly scan or TIFFA scan

An anomaly scan or TIFFA scan (Targeted Imaging for Fetal Anomalies) is the most critical scan carried out in your second trimester. This pregnancy ultrasound scan is also referred to as a 20 week ultrasound scan or Level II ultrasound scan. This ultrasound scan is usually done between 18 to 20 weeks of pregnancy. Still, it can be performed up to 22 weeks of gestational age.
The scan closely examines the fetus and your uterus, your baby’s health, growth, and development. Any deformity, if present, is detected in the anomaly scan, although it might not pick up every condition. The scan gives side views of the fetus using 2D black and white images. 3D or colour images are also used. You can ask the sonologist for your baby’s pictures or film the entire video and bring back a CD or DVD for your home.
tiffa1

What is best time to schedule and perform anomaly scan or TIFFA scan?

Though this pregnancy ultrasound scan can be performed anytime during the 18 to 22 weeks of pregnancy, it is best to perform it within the 18 to 20 weeks of conception. According to The Medical Termination of Pregnancy Act 1971, abortion can be performed up to 19 weeks and 6 days of conception. Hence, if there is any severe complication noticed in the baby in an anomaly scan, the parents, if decides, can terminate the pregnancy. This helps to mitigate further complications for the mother’s health.
Another reason to perform this scan within 18 to 20 weeks of pregnancy is the growth of your baby. By the 19th week, the baby is around 6 inches long and develops the anatomical structures like an adult, so any structural abnormality can be best picked up at this stage. The internal organs start to grow and mature. The brain develops millions of motor neurons. You might begin to feel your baby moving inside your uterus. 19 to 20 weeks is the best gestational age suggested by the obstetrician for the anomaly or TIFFA scan.

Importance of anomaly scan or TIFFA scan and why to go for it?

The anomaly scan or the TIFFA scan examines the fetus from head to toe monitoring the overall growth, development, and health. The sonographer checks the baby’s anatomy and examines any structural problem from head to toe. The scan can measure the size and weight of the fetus. It also looks at the position of your placenta, the umbilical cord, and amniotic fluid around the fetus. Any abnormal positioning of the placenta might result in miscarriages or heavy bleeding during pregnancy and can cause many complications to the mother and the baby.
The anomaly scan or 20 week ultrasound scan is significant as it records any deformity in the fetus. Although certain anomalies cannot be detected during sonography, about 50% of down syndrome conditions and congenital heart defects are detected. There can be cases where the baby’s organs are not developed properly. In some cases, there can be some abnormalities that cannot be treated after the baby’s birth. Some may lead to the death of the fetus during the remaining pregnancy or immediately after the birth. All this needs to be detected, examined, and studied. So this scan is critical so that your obstetrician can suggest the necessary actions, medications, and reassurance about your baby’s health during the remaining part of pregnancy.

What baby details can be found from an Anomaly scan or TIFFA scan?

This pregnancy ultrasound scan looks closer to every detail of your child’s normal and healthy development. The scan can identify severe abnormality conditions in the fetus. However, not all deformities can be analyzed from the Anomaly scan. Your baby may look perfectly healthy and normal in the scan yet be born with abnormalities. Some of the conditions detected are:
  • Anencephaly (98%)
  • Gastroschisis (98%)
  • Edwards’ Syndrome (Trisomy 18) (95%)
  • Patau’s Syndrome (Trisomy 13) (95%)
  • Bilateral Renal Agenesis (84%)
  • Exomphalos (80%)
  • Cleft Lip (75%)
  • Open Spina Bifida (90%)
  • Diaphragmatic Hernia (60%)
  • Lethal Skeletal Dysplasia (60%)
  • Down Syndrome (50%)
  • Congenital Heart Disease (50%)

For abnormalities , click here…

How the anomaly scan or TIFFA scan is done?

The scanning process occurs quickly, painlessly, and skillfully by trained medical professionals. At first, the sonographer or the radiologist will apply the gel all over your abdomen. Then, a handheld probe moves it across the area to be examined. The gel used allows good contact between the probe and your skin.
You will see pictures of your baby on the ultrasound screen. Often, to get clear images of your baby, the sonographer might give a little pressure on your abdomen while moving the probe, which might be a little uncomfortable. Still, it is absolutely safe and done with caution.
The entire procedure takes around 30 to 40 minutes. But it can be delayed if your baby is moving a lot or if a sonologist couldn’t examine any part in detail due to the baby’s position. Sonologist may ask you to wait for some more time until the baby gives the correct position or call you back some another day to examine it. There’s nothing to worry about. Just lie comfortably and enjoy the entire process. Yes, one of the most incredible and most beautiful emotional moments you will be experiencing and taking back home is the picture of your baby. Following are a few things to take care of while visiting the sonologist for an anomaly scan:
 
1. Carry your obstetrician’s prescription of sonography advised.
2. Carry your previous Ultrasound scan reports. The doctor may want to see them before performing the anomaly scan.
3. You do not need to be with a full bladder for an anomaly scan.
4. Take out proper time while going for an anomaly scan. This scan may take more time than other scans, so do not hurry.

Is it necessary to take the anomaly scan or TIFFA scan?

The Anomaly scan or TIFFA scan is one of the most crucial pregnancy ultrasound scan. This scan is done to see the growth and position of the fetus and detect disabilities if any. This scan helps to detect the abnormalities and, in some extreme conditions, enables you to decide to continue the pregnancy. As many of the pregnancy checkups and treatments are the mother’s personal choice, this one is also a personal choice. But this scan is highly recommended by all pregnancy doctors. Consult your obstetrician if you have any questions on the importance and necessity of this scan.

Is there any harmful effect of the anomaly scan or TIFFA scan on the baby?

Numerous scientific studies verify that a pregnancy ultrasound scan is harmless to a fetus, embryo, pregnant lady, adult, or child. This abnormality scan of the TIFFA scan is absolutely safe. It is performed by a professional and trained person in the field.

When do I receive my anomaly scan report or TIFFA scan report?

The report of an anomaly scan is quite detailed. The report may include important information about your baby, its health conditions, overall growth, size, and progress. It also contains details about the baby’s internal organs and their normal and proper development status. The report includes positioning the placenta and recording any major and minor abnormalities in the fetus or the mother. You should be able to receive the report of your anomaly scan or TIFFA scan, usually on the same day. Even if there is some delay in getting the report, you need not panic. Some reports may take time to understand the detected anomalies and make the correct diagnosis. Talk to your obstetrician if there is any delay and feel a little worried.

What happens if any abnormality of the baby is detected in the report?

In most cases, the fetus develops normally, and no complications are recorded. In case of any anomaly noticed in the anomaly scan or TIFFA scan, the sonographer will ask you to take a second scan. Lesser severe abnormalities can improve with time, or surgeries can be provided once the baby is born. Whereas, in case of severe anomalies, the family is given care, support, and information about other processes, including termination of pregnancy and the appropriate time for the action.
Moreover, it is to be remembered that there are cases when no abnormality is recorded in the scan. Yet, the baby is born with an undetected anomaly. There are also cases where fetuses showing certain complications during pregnancy are born perfectly healthy and normal. Therefore, don’t panic or be heartbroken if any problem is detected. Firstly, we advise you to discuss it with your obstetrician before settling on a solution. Then, the final decision is solely that of yours.
A girl, when bleeds, transform into a woman. A woman is then blessed to bring life in her womb, to nurture a soul, and in doing so, she becomes a mother, an unconditional love giver. Conceiving a child, perhaps undoubtedly, the most precious gift for a woman and the entire chapter of one’s pregnancy from the first to the third trimester is essentially crucial. Therefore, one must rigorously follow the routine checkups and scans that her obstetrician or gynecologist recommends.
The journey from an embryo till the wonder is born is typically nine months. Still, it serves one of the best and greatest phases of her life to rejoice forever. Therefore, we wish every mother to enjoy this unique and sublime ride of her life and celebrate it cheerfully. It is impertinent to take care of yourself and your baby. Hence, following the correct medications, proper diet, regular checkups, and prescribed scans is crucial during pregnancy. An anomaly scan or TIFFA scan is one such important scan of the 18 to 20 weeks of gestational age. This scan checks everything from your baby’s heartbeat to its physical development. Including it as a part of the second trimester of your pregnancy journey is advised by most doctors. If you have any questions about this, visit the obstetrician or feel free to ask me any questions.
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Second Trimester Ultrasound

2nd trimester

Cardiac scan / Fetal 2D echocardiography

Cardiac pregnancy scan is meant to check the structure and function of a baby’s heart. This scan examines how blood flows through your baby’s arteries and veins. This sonography is one of the optional sonographies during pregnancy. This pregnancy ultrasound scan is recommended typically in high-risk pregnancies.

This scan also looks out for abnormalities such as holes in the heart, narrowing of arteries, valves that don’t open and close properly. The cardiac scan is necessary for the following conditions:

  • You were born with a heart defect
  • You've already had a baby with a heart defect
  • You have diabetes. This means you are at a slightly higher risk of having a baby with a heart defect
  • You take certain drugs that can increase the risk of heart problems, such as some medications for epilepsy
  • Your nuchal translucency (NT) scan shows that your baby has fluid at the back of her neck of 3.5mm or more but appears to have normal chromosomes
Fetal Echo
fetal echo2

Third Trimester Ultrasound

erd trimester

Cardiac pregnancy scan is meant to check the structure and function of a baby’s heart. This scan examines how blood flows through your baby’s arteries and veins. This sonography is one of the optional sonographies during pregnancy. This pregnancy ultrasound scan is recommended typically in high-risk pregnancies.

Late pregnancy welfare scan or third trimester growth scan

The third-trimester growth scan, also known as the late pregnancy welfare scan, is usually performed between 28–32 weeks and again between 36–39 weeks of pregnancy. The number and frequency of these scans depend on the baby’s growth, health, and any medical concerns.

By this stage, the baby’s facial features and body structures are clearly visible, allowing better imaging. This scan evaluates whether the baby is growing properly by measuring weight, size, and other body parameters. It also confirms the baby’s position inside the womb.

Additionally, the scan assesses the placenta’s location to ensure it is not too close to the cervix and checks the level of amniotic fluid required for healthy development. Any signs of internal bleeding, discomfort, or conditions such as uterine fibroids are also examined.

In multiple pregnancies, such as twins or triplets, growth scans are especially important to monitor each baby’s development and detect any potential complications early.

Obstetric Doppler ultrasound (28-32 week ultrasound scan)

Proper blood flow to the uterus, placenta, and umbilical cord is essential for the healthy development of the baby during pregnancy. Any condition that restricts this blood supply can affect the baby’s growth and well-being, making regular monitoring important.

A Doppler ultrasound scan, usually performed between 28 to 32 weeks of pregnancy, is used to assess blood flow. Unlike a regular ultrasound, this scan shows how blood moves through the vessels. It helps detect any blockage or reduced circulation between the placenta and the baby.

This scan measures blood flow through the umbilical cord and to the baby’s vital organs, ensuring the baby receives sufficient oxygen and nutrients for proper growth.

fetal ultrasound1
fetal ultrasound2

Are all the pregnancy ultrasounds safe?

Pregnancy ultrasound scans are completely safe, as they use sound waves rather than radiation. These scans are performed by trained professionals such as sonographers, radiologists,. Conducted at different stages of pregnancy, they provide valuable information about the health and well-being of both the mother and the unborn baby.

Who performs the ultrasounds?

Skilled and trained medical professionals (Radiologist) perform these pregnancy ultrasound scan with utmost care and proficiency. With these dating scan and growth scan, they can understand the overall age and health of the baby.

Where can one get these pregnancy ultrasound scan done?

The pregnancy ultrasound scan are performed in various hospitals. There are also specialized labs that can perform these pregnancy scan. But it is imperative to talk and discuss it with your Radiologist to guide you to selecting the correct scan. Your gynecologist’s prescription is mandatory to do any pregnancy ultrasound scan.

Pregnancy ultrasound scan schedule summary

Above are the details about each ultrasound scan required during pregnancy. Below is a quick summary of these scans.
TrimesterWeekScan namePurpose
1st6 to 8

Early pregnancy or dating scan

Confirm the pregnancy, its position, and estimate the baby’s age.
11 to 13

NT / ND scan

Measures Nuchal Translucency, check for nasal bone, examine the spinal column. Uterine artery doppler is also checked.
2nd18 to 20

Anomaly or TIFFA scan

Check anatomic structures and find out a defect in the baby and placenta. Most important pregnancy scan.
24 to 26

Cardiac scan / Fetal echocardiography

Evaluate structural and functional integrity of fetal heart.
3rd28 to 32

Pregnancy welfare and growth scan

Check the progress of the baby’s growth and status of liquor (fluid around the baby).
28 to 32

Obstetric doppler scan (Optional)

Measures the blood flow through the umbilical cord to the different internal organs of the developing baby’s body
36 to 40

Growth scan. Obstetric doppler scan (If needed)

Check baby’s growth, position, amount of liquor, and blood flow to the baby.

This article explains the most important pregnancy ultrasound scans, including the dating scan, anomaly scan, and growth scan, which are routinely recommended during pregnancy. Throughout the nine-month journey, a mother plays a vital role in nurturing both herself and her unborn baby. Regular doctor visits, prescribed medications, ultrasounds, a healthy diet, and a balanced lifestyle are essential parts of prenatal care.

In a normal pregnancy, these standard scans are usually sufficient. However, in special cases such as twin or triplet pregnancies, fetal growth concerns, or high-risk conditions, more frequent ultrasounds may be advised by the gynecologist. These scans help closely monitor the baby’s development and ensure timely medical support.

Watching your baby grow through each stage of pregnancy is a truly emotional and memorable experience, from a tiny group of cells to a fully formed life inside the womb.

Dr. Mayank Gupta

M.B.B.S., M.D Radiodiagnosis (FMF , UK Certified) Ex Sr. Residency BVP-Pune , Rajiv Gandhi Cancer Hospital, New Delhi Ex Associate Consultant, Sir Ganga Ram Hospital, Delhi Society of Foetal Medicine IRIA, IMA, International Society of Ultrasound in Obstetrics and Gynecology (ISUOG)

Disclaimer

This article is for general awareness only. It should not be considered as a medical advice and should not replace a consultation with a doctor. Every case is unique; please seek professional medical guidance for your personal condition.

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