Pregnancy is filled with exciting milestones, and one of the most important is the anomaly scan, also known as the Level 2 ultrasound, mid-pregnancy scan, or TIFFA (Targeted Imaging for Fetal Anomalies) scan.
For many parents, this ultrasound offers the first detailed glimpse of their baby’s growth and development. More importantly, it helps doctors identify structural abnormalities early, allowing timely medical planning if needed.
If your doctor has recommended an anomaly scan, you probably have many questions. When should it be done? Is it painful? How long does it take? Can you skip it?
This comprehensive guide answers all these questions and explains everything you need to know about anomaly scans in a simple, easy-to-understand way.
What Is an Anomaly Scan?
An anomaly scan is a detailed ultrasound examination performed during the second trimester of pregnancy. It carefully checks your baby’s organs, bones, face, heart, spine, limbs, and overall development.
Unlike an early pregnancy scan that confirms pregnancy or estimates the due date, an anomaly scan focuses on detecting structural birth defects and developmental abnormalities.
The scan also evaluates:
- Baby’s growth
- Placenta position
- Umbilical cord
- Amniotic fluid levels
- Cervix (in some pregnancies)
- Fetal movements
- Heart rate
It is considered one of the most important ultrasound scans during pregnancy.
Why Is an Anomaly Scan Important?
Many congenital conditions develop while the baby is growing inside the womb. Detecting them early helps doctors:
- Plan further investigations
- Arrange specialist consultations
- Decide if additional fetal medicine evaluation is required
- Monitor pregnancy more closely
- Plan delivery at an appropriate hospital if specialized care is needed
Early diagnosis allows parents to understand their baby’s condition and receive proper counselling.
Which Week Is Best for an Anomaly Scan?
The best time for an anomaly scan is between 18 and 22 weeks of pregnancy, with 20 weeks often considered ideal.
At this stage:
- Baby’s organs are fully formed enough for detailed assessment.
- The baby is large enough to visualize clearly.
- There is adequate amniotic fluid for better imaging.
Most specialists recommend scheduling the scan around 19–20 weeks unless advised otherwise.
Which Month Is Perfect for an Anomaly Scan?
The ideal time falls during the fifth month of pregnancy, extending into the early sixth month.
Typically:
- 18 weeks = Beginning of the fifth month
- 20 weeks = Mid-fifth month
- 22 weeks = Early sixth month
This window provides the best opportunity to assess fetal anatomy accurately.
Is 22 Weeks Too Late for an Anomaly Scan?
No.
An anomaly scan performed at 22 weeks is still considered within the recommended time frame.
However, delaying beyond this period may reduce the opportunity for early diagnosis and additional testing if abnormalities are detected.
Whenever possible, doctors prefer completing the scan between 18 and 20 weeks.
How Many Times Is an Anomaly Scan Done in Pregnancy?
Usually, an anomaly scan is performed once during pregnancy.
However, your doctor may recommend a repeat scan if:
- Baby’s position prevents clear visualization.
- Some organs cannot be assessed completely.
- Maternal obesity limits image quality.
- Low amniotic fluid affects visibility.
- A suspected abnormality requires follow-up.
In high-risk pregnancies, additional fetal ultrasounds may also be advised.
What Does an Anomaly Scan Check?
A detailed anomaly scan examines nearly every part of the baby’s body.
Brain
The sonologist checks:
- Brain structure
- Skull development
- Ventricles
- Cerebellum
- Neural tube
Conditions such as anencephaly or other brain abnormalities may be identified.
Face
The scan assesses:
- Lips
- Nose
- Eyes
- Facial profile
It can detect conditions such as:
- Cleft lip
- Certain facial abnormalities
Spine
The entire spinal column is examined to rule out conditions like:
- Spina bifida
- Neural tube defects
Heart
The fetal heart receives special attention.
Doctors evaluate:
- Four heart chambers
- Heart rhythm
- Major blood vessels
- Blood flow
Many congenital heart defects can be detected during this scan.
Abdomen
The ultrasound examines:
- Liver
- Stomach
- Intestines
- Abdominal wall
It helps identify abdominal wall defects and gastrointestinal abnormalities.
Kidneys and Bladder
The scan evaluates:
- Kidney development
- Urinary bladder
- Urinary tract
Conditions like bilateral renal agenesis may sometimes be identified.
Limbs
Doctors examine:
- Arms
- Legs
- Hands
- Feet
- Fingers
- Toes
- Bone growth
This helps detect skeletal abnormalities.
Placenta
The scan also checks:
- Placental position
- Placental maturity
- Placenta previa
Amniotic Fluid
Adequate fluid is essential for healthy fetal growth.
The sonologist measures amniotic fluid volume to identify:
- Polyhydramnios
- Oligohydramnios
Umbilical Cord
The scan evaluates:
- Cord insertion
- Blood vessels
- Blood circulation
Conditions That May Be Detected
An anomaly scan can detect numerous structural abnormalities, including:
- Congenital heart defects
- Cleft lip
- Spina bifida
- Brain abnormalities
- Neural tube defects
- Kidney abnormalities
- Skeletal dysplasia
- Abdominal wall defects
- Limb abnormalities
- Some chromosomal abnormality markers
It is important to remember that no ultrasound can detect every possible birth defect.
Can an Anomaly Scan Detect Down Syndrome?
An anomaly scan cannot diagnose Down syndrome.
However, it may identify soft markers associated with chromosomal abnormalities.
If multiple markers are seen, your doctor may recommend:
- NIPT
- Amniocentesis
- Genetic counselling
- Additional fetal medicine evaluation
Is an Anomaly Scan Painful?
No.
An anomaly scan is completely painless.
During the procedure:
- Gel is applied to your abdomen.
- A handheld ultrasound probe is moved gently across your stomach.
Some women may feel slight pressure if the sonographer needs clearer images, but the scan should not be painful.
How Many Minutes Will an Anomaly Scan Take?
An anomaly scan usually takes 30 to 45 minutes.
Sometimes it may last up to 60 minutes if:
- Baby changes position frequently.
- Images need to be repeated.
- A detailed cardiac examination is required.
- Certain organs are difficult to visualize.
The duration depends on the baby’s position and how easily all anatomical structures can be examined.
Do You Need a Full Bladder?
Usually, no.
By the second trimester, the enlarged uterus provides sufficient visualization without requiring a full bladder.
However, your diagnostic centre may provide specific instructions before your appointment.
How Should You Prepare?
Preparation is simple.
You should:
- Wear comfortable clothing.
- Carry previous ultrasound reports.
- Bring your doctor’s prescription.
- Arrive on time.
- Stay hydrated unless instructed otherwise.
Follow any specific preparation instructions provided by your healthcare provider.
What Is the Rule of 3 in an Anomaly Scan?
The “Rule of 3” is an educational concept sometimes used during systematic fetal ultrasound examinations. While protocols may vary, it generally refers to assessing fetal anatomy in an organized manner by reviewing structures from three perspectives or groups to ensure that no major organ system is overlooked.
In clinical practice, sonologists follow standardized fetal anatomy checklists rather than relying solely on a single “Rule of 3.” The exact protocol depends on national and international ultrasound guidelines and the equipment used.
How to Change Baby Position for an Anomaly Scan?
Sometimes the baby is curled up or facing away from the ultrasound probe, making certain structures difficult to see.
Your sonographer may ask you to:
- Walk for 10–15 minutes.
- Change your position.
- Turn onto your side.
- Empty your bladder.
- Drink some water.
- Gently move around.
These simple measures often encourage the baby to change position naturally.
Why Is the Baby Not Moving During an Anomaly Scan?
Many parents worry if their baby appears still during the scan.
In most cases, there is nothing to worry about.
The baby may simply be:
- Sleeping
- Resting
- Facing away from the probe
If movement is needed for better imaging, the sonographer may ask you to move around or wait for a short time.
Can You Skip an Anomaly Scan?
Technically, yes—but it is not recommended.
The anomaly scan is one of the most valuable prenatal investigations because it can identify many structural abnormalities that are not detectable through routine blood tests or physical examinations.
Skipping this scan means missing an important opportunity to assess your baby’s development and detect conditions that may benefit from early planning or specialized care. If you have concerns about the scan, discuss them with your obstetrician before deciding.
Can an Anomaly Scan Reveal the Baby’s Gender?
The primary purpose of an anomaly scan is to evaluate fetal anatomy and development, not to determine the baby’s sex.
In India, disclosing the sex of the fetus is prohibited by law under the PCPNDT Act, and healthcare providers must comply with these regulations.
Are There Any Risks?
Ultrasound uses sound waves, not radiation.
When performed by trained professionals using appropriate medical guidelines, an anomaly scan is considered safe for both the mother and the baby.
There are no known harmful effects from medically indicated diagnostic ultrasound examinations.
What Happens If an Abnormality Is Found?
Finding an abnormality does not always mean there is a serious problem.
Depending on the findings, your doctor may recommend:
- Repeat ultrasound
- Fetal echocardiography
- Genetic counselling
- NIPT
- Amniocentesis
- Consultation with a fetal medicine specialist
- Regular follow-up scans
Many findings are minor or resolve on their own, while others may simply require closer monitoring or delivery planning.
Frequently Asked Questions (FAQs)
1. Which week is best for an anomaly scan?
The ideal time is 18 to 22 weeks, with 20 weeks considered the best for a detailed assessment.
2. How many times is an anomaly scan done in pregnancy?
Usually once. A repeat scan may be recommended if the baby’s position prevents complete evaluation or if follow-up is required.
3. Is an anomaly scan painful?
No. It is a painless ultrasound performed over the abdomen using a handheld probe and ultrasound gel.
4. How many minutes will an anomaly scan take?
Most scans take 30 to 45 minutes, although some may take up to an hour depending on fetal position and the complexity of the examination.
5. Can I skip an anomaly scan?
Although you can choose not to have it, it is strongly recommended because it provides important information about your baby’s structural development and overall health.
6. What is the Rule of 3 anomaly scan?
The term generally refers to a structured approach to reviewing fetal anatomy. In practice, sonologists follow comprehensive, standardized anatomical checklists rather than a single “Rule of 3.”
7. How can I change my baby’s position for an anomaly scan?
Walking for a few minutes, changing positions, lying on your side, or waiting briefly often encourages the baby to move into a better position for imaging.
8. Why is my baby not moving during the anomaly scan?
The baby may simply be sleeping or resting. This is common and usually not a cause for concern.
9. Is 22 weeks too late for an anomaly scan?
No. An anomaly scan at 22 weeks is still within the recommended window, although earlier scheduling between 18 and 20 weeks is generally preferred.
10. Which month is perfect for an anomaly scan?
The fifth month of pregnancy (around 18–20 weeks) is considered the ideal time, extending into the early sixth month if needed.
Final Thoughts
An anomaly scan is one of the most significant prenatal ultrasounds because it provides a comprehensive assessment of your baby’s anatomy during a critical stage of development. Performed between 18 and 22 weeks of pregnancy, it helps identify many structural abnormalities, evaluates fetal growth, and offers reassurance when development appears normal.
While most anomaly scans show healthy fetal development, the examination also plays an important role in identifying conditions that may require closer monitoring or specialist care. Attending this scan at the recommended time and choosing an experienced diagnostic centre can help ensure the most accurate evaluation and support a well-informed pregnancy journey.
Why Choose Sparsh Diagnostic Centre for Your Anomaly Scan?
At Sparsh Diagnostic Centre, your pregnancy care is in trusted hands. With advanced ultrasound technology and a team of trained radiologists and fetal medicine experts, we offer:
High-resolution imaging
Expert anomaly detection
Warm and personalized care
Clean, modern facility
Convenient timings: Mon to Sat: 7 AM – 9 PM, Sunday: 7 AM – 3 PM
📞 Call us at 9830117733 or 8335049501 to book your scan today.
An anomaly scan is more than just a routine test—it’s a vital window into your baby’s health and development. It provides crucial insights that help parents prepare, doctors plan, and ensure that both mother and baby receive the best possible care.
Whether everything is fine or further steps are needed, this scan empowers you with information, reassurance, and timely action.
If you’re pregnant and between 18–22 weeks, don’t miss this essential scan. Schedule your anomaly scan with Sparsh Diagnostic Centre today and embrace motherhood with peace of mind.
#BhaloTheko
Disclaimer:
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
