The anomaly scan checks the baby's organs and growth in detail at 18 to 20 weeks. Learn what it looks for, how to prepare and what to do if something is found.
The anomaly scan, also called a Level 2 ultrasound or TIFFA scan, is a detailed ultrasound done at about 18 to 20 weeks of pregnancy. It checks the baby's brain, face, heart, spine, abdomen, kidneys and limbs, the placenta, amniotic fluid and the cervix. Most babies are normal, and the scan gives reassurance and finds problems that can be planned for.
Why Is It Done at 18 to 20 Weeks?
At this stage the baby is large enough to see small structures, and there is still enough fluid to give clear views. Some problems can be seen only at this time. If a problem is found, there is time for further tests, counselling and planning. See first trimester dating scan.
Part checkedWhat the sonologist looks atBrain and skullShape, ventricles, cerebellumFace and neckLips, palate, profileHeartFour chambers and outflow vesselsSpine and abdomenSpine closure, stomach, bowel, kidneys, bladderLimbs and bonesArms, legs, hands and feetPlacenta, fluid and cervixPosition, amount of fluid, cervical lengthWhat Can It Detect?
- Neural tube defects such as spina bifida
- Heart defects (many, but not all)
- Cleft lip, kidney and bowel problems
- Limb abnormalities
- Low-lying placenta and abnormal fluid
- Short cervix that raises the risk of early labour
What It Cannot Do
No ultrasound finds every abnormality. Some problems, such as small heart defects, hearing loss, many genetic conditions and some developmental issues, may not be visible. The baby's position, maternal weight and fetal movement can limit views, and a repeat scan may be needed. A normal scan reduces but does not remove the risk.
Preparation
A full bladder is usually not needed in the second trimester. Bring your previous reports and the dating scan. The scan takes 30 to 45 minutes, and your partner can usually attend. Wear a two-piece outfit for easy access. See pelvic ultrasound.
If Something Is Found
Do not panic. A suspicious finding is usually followed by a repeat or detailed scan, a fetal echocardiogram for heart concerns, blood tests or amniocentesis, and review by a fetal medicine specialist. Many findings are minor or treatable. Fetal MRI may be used for some brain or body problems. See MRI during pregnancy.
A Practical Example
Shalini, 30, has her anomaly scan at 19 weeks. The sonologist sees a normal baby, but the placenta covers part of the cervix opening. The doctor explains that it often moves up, advises a follow-up scan at 32 weeks and gives warning signs of bleeding. By 32 weeks, the placenta has moved up, and she plans a normal delivery.
After the Scan and Next Steps
Take the report to your obstetrician. If all is normal, continue regular antenatal visits, take iron, calcium and folic acid as advised, eat a balanced diet and track fetal movements. If any problem is found, ask for a referral to a fetal medicine specialist and take time to understand options and support.
Questions to Ask Your Doctor
- Were all structures seen clearly?
- Is a repeat or fetal echo needed?
- Is my placenta or cervix a concern?
- When will my next growth scan be done?
Common Mistakes to Avoid
- Ignoring a recommendation for a repeat scan.
- Comparing your report with someone else's.
- Searching the internet instead of asking your doctor.
Booking, Timing and Report
Ultrasound is usually available without a long wait, and many scans can be done the same day. Carry your doctor's prescription and old ultrasound reports, and follow the instructions about a full or empty bladder or fasting. The scan takes 15 to 30 minutes, and the report is usually ready the same day.
Frequently Asked Questions
When is the anomaly scan done?
At about 18 to 20 weeks.
Does it find all problems?
No; it finds many but not all.
Do I need a full bladder?
Usually not.
Is the scan safe?
Yes.
Why might I need a repeat scan?
The baby's position or movement can limit views.
What is a TIFFA scan?
Another name for the anomaly scan.
Can it show the baby's sex?
It can, but sex determination is not allowed for non-medical reasons under Indian law.
How long does it take?
About 30 to 45 minutes.
When is the report ready?
Usually the same day.
Book Your Test at Ganesh Diagnostic
Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.
This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.
