Anomaly/ Level II Scan (18- 20 weeks)

Anomaly scan/ Level II scan

This is a detailed ultrasound scan carried out between 18 and 21 weeks of pregnancy. The scan is used to check the physical development of your baby and to look for any major congenital anomaly in the baby, although it cannot pick up every condition.

Anomaly scan is offered to every pregnant woman, but it’s the decision of the parents if they want to take it or not.

Why is anomaly scan necessary and what does the scan look for?

The scan looks at all of the baby’s organs including heart, brain, kidneys, abdomen, face, spine and bones. It helps to identify grave conditions in the baby, if any. Some of these anomalies are:

  • Neural tube defects- anencephaly, spina bifida, meningocoele etc.
  • Face defects- Cleft lip, cleft palate, retrognathia, micrognathia, absent nasal bone etc.
  • Abdomen- Diaphragmatic hernia, gastroschisis, omphalocoele, renal agenesis, megacystitis etc.
  • Serious cardiac diseases
  • Lethal Skeletal dysplasias
  • Trisomy- Trisomy 21, Trisomy 13, Trisomy 18.
If there’s a condition, will the scan find it?

Some deformities can be picked up more clearly than others.
Neural tube defects like open spina bifida, can usually be seen clearly on a scan, and can be detected in around 9 out of 10 babies.
But other conditions such as heart defects are more difficult to see. The scan will find about 50% of babies who have heart defects.
Most of the major anomalies that are life threatening for the baby can be picked up during anomaly scan.

Can my husband come to the scan with me?

No, in India any family member including spouse is not allowed inside the sonography room.

Can the scan harm me or my baby?

No. Ultrasound in pregnancy is the safest test available to check for you baby growth and development. It does not harm the mother or the baby.

When will I get the results of the scan?

The scan report is handed over immediately to the parents unless there is some doubtful finding where the doctor may ask for a repeat scan after a few days for confirmation of the findings.

What if the scan shows something abnormal?

If any suspicious finding is there, the doctor may ask for a re-scan after a few days or may send you to a senior for a second opinion.
It is important to understand that scans cannot find all conditions, and there’s always a chance that a baby may be born with a health issue. This is because many times there is poor visibility due to lack of amniotic fluid or maternal obesity. Another reason is that the development of the baby is a continuous process; so many abnormalities develop in later phase of fetal life.

Will I need any further tests?

Yes, even if your ultrasound findings are normal, you will be offered serial growth scans to look for growth of baby at regular intervals. This is because fetal development is an ongoing process and deformities may develop at any point of time. So, for early diagnosis and management it is necessary to follow up with your doctor on time and check with timely scans.


Q1. Is Anomaly Scan important?

Ans. Yes. Anomaly scan is the most important scan during pregnancy. It is done between 18 weeks to 20 weeks of gestation and allows for visualization of fine details about the fetal organs and other body parts. Apart from monitoring of fetal growth, anomaly scan helps in timely detection of any congenital defect in baby. This further helps in planning the management options. Correctable disorders are left for treatment after childbirth whereas those with lethal defects are planned for termination before 20 weeks.

Q2. Which week is best for anomaly scan?

Ans. In India, anomaly scan or Level II scan is advised from 18 to 20 weeks of pregnancy. This allows timely diagnosis and management of congenital disorders. This is the best time for scanning as the fetus is fully developed and all minute details can be seen clearly on ultrasound. As the baby grows, the visibility reduces and there are chances of missing any minor defect.

Q3. Can too many scans harm the baby?

Ans. Ultrasound is absolutely safe for the baby and mother. Ultrasound utilizes sound waves to create images unlike X-rays and CT scan, which emit potentially hazardous waves that can be lethal. These sound waves are absolutely safe and don’t cause any kind of minor or major damage.

Q4. Does anomaly scan tell gender?

Ans. No. In India, sex determination is prohibited by law and is a punishable offence. It is illegal to determine sex of the baby and to document it. Any doctor or parent found guilty of breaking the laws have to face severe consequences. So, as responsible citizens of India we should not opt for sex determination.

Q5. How is a level II ultrasound different?

Ans. Level 2 ultrasound or anomaly scan is similar to standard obstetric ultrasound. The baby at this time is sufficiently mature which allows to focus on all its body parts such as heart, brain, kidney, abdomen, upper and lower limbs. This in turn can help in early diagnosis of congenital anomalies and birth defects and timely decision making.

Q6. Can you eat before a level 2 ultrasound?

Ans. Yes, you can have your normal meals before level II ultrasound or any other obstetric scan. If you have been advised for upper abdomen sonography for any reason, then you should avoid having meals before your scan.

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Dr. Mayuri Kothiwala

Gynecologist, Obstetrician; Laparoscopic Surgeon & Infertility Specialist

Dr Mayuri Kothiwala is an experienced Gynecologist in Jaipur taking care of all Obstetrical and Gynecological related health concerns at every stage of women. Having worked for 10+ Years, she is passionate to explore her expertise in rural and remote areas of Rajasthan to educate, diagnose & treat women for their obstetric & gynecology issues, laparoscopy procedures, oncology & urogyne concerns. Dr Mayuri uses the latest and most advanced techniques including sonography, ultrasound, laparoscopy and lasers for early diagnosis and timely management of her patients.

Dr. Mayuri Kothiwala Clinic

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