Do I have to have a 20-week ultrasound?
In fact, feelings can run very deep for some parents in relation to being confronted with their baby having a potential abnormality. For them, the issue of possibly being faced with the dilemma of what to do in terms of continuing with the pregnancy or not is enough to decline the recommendation of a screening ultrasound. Spiritual and religious beliefs also factor strongly.
Others are genuinely fearful of what the 20 week ultrasound may detect. Some are unable to face their fears and choose to avoid the experience altogether. Occasionally, in cases where there is a family history of genetic disorders, counseling may be necessary to support parents in making the right choice for them.
Some parents prefer to be surprised and choose to meet their baby for the first time when it is born. There can also be the feeling among some couples that in days gone by, ultrasound was not available, and the majority of pregnancies evolved into healthy, well, full- term babies. Adopting this philosophy just sits well for some expectant couples.
Will the 20-week ultrasound be clear?
For partners who've not experienced pregnancy symptoms firsthand, seeing their baby on an ultrasound screen can be the first time they really, truly believe the baby exists.
The ultrasound will pick up images of your baby's organs in a series of cross-sections. This can be confusing at first, until you become used to the images. Your eyes will adjust. Your baby's bones will be white on the screen and the amniotic fluid will appear as black. Their tissues will be grey and have a speckled appearance.
What does a 20-week ultrasound detect?
- Checking how many babies are present. If this is your first scan it's important to know if you are carrying one or more babies.
- The position of the baby.
- Your baby's spine and abdominal wall.
- The size, weight, and general appearance of your baby.
- If the size of your baby is matching your gestational assessment.
- The position of the placenta and cord and the amount of amniotic fluid. If the placenta is assessed as lying low, a repeat ultrasound at 30 weeks gestation may be recommended.
- Your baby's brain, heart, lungs, stomach, esophagus and trachea, kidneys, and general anatomy.
- The limbs, the fingers, and toes (counted), the facial appearance, lips and palate.
- Measurements of your baby's head, biparietal diameter, length, and a measurement of their femur will also be taken. These measurements are compared with the average for babies of the same gestation.
Will my 20-week ultrasound detect all abnormalities?
What if an abnormality is detected during my 20-week ultrasound?
The ultrasound findings will be examined and reported on by a specialist sonographer and/or radiologist. Depending on the level of concern, another ultrasound with further diagnostic testing may be ordered.
Sometimes an abnormality or soft marker is detected on ultrasound, and this causes parents a lot of anxiety and stress. But in the coming weeks, as the pregnancy progresses, it's not uncommon for slight deviations from normal to resolve themselves without any specific treatment or management. Therefore, a repeat ultrasound may be recommended.
Are we having a boy or a girl?
Be aware though that sometimes it is very clear on the screen what sex the baby is, which might change any plans to keep this a secret until you meet your little one face to face. Alternatively, your baby may be lying in a position where it is not possible to see their genitals and unless they are willing to move around a bit, their sex will remain a mystery.
It's common for expectant parents to be given a photo of their 20 week ultrasound. This can be viewed later at your own leisure and, if you want to, shared with your friends and family. It has become routine for imaging centers to request of parents that no photographs or videos are taken during ultrasounds and any recordings or images can only be supplied by the sonography service.
This is due in part to the possibility of litigation if complications arise and they've not been detected during the ultrasound. You may also be asked to sign a disclaimer or permission form before your procedure.
What do I need to do to prepare for my 20 week ultrasound?
You won’t need to have a full bladder for this ultrasound, unlike the 12 week one. But the sonographer may request you don’t urinate for 30 minutes or so before your procedure as some urine in your bladder will help with visualizing the baby. This is because a semi-full bladder will help to push your uterus up higher in the pelvis, making it easier for the sonographer to see.
Don’t worry if the sonographer seems so focused on the procedure that they don’t constantly talk to you. When there are appropriate times for them to describe what they're looking at, they’ll describe their findings to you.
The information of this article has been reviewed by nursing experts of the Association of Women’s Health, Obstetric, & Neonatal Nurses (AWHONN). The content should not substitute medical advice from your personal healthcare provider. Please consult your healthcare provider for recommendations/diagnosis or treatment. For more advice from AWHONN nurses, visit Healthy Mom&Baby at health4mom.org.