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The Big Ultrasound

The time has come, the walrus said, to have a closer look at that babe in your belly!

The anatomy scan ultrasound, or level 2 ultrasound, is an amazing experience; and during the pandemic, it’s one of the few milestones in pregnancy that will require you to actually go to your prenatal visit in person (nowadays, many visits have shifted to Telehealth).

By this time, all your baby’s major bits and pieces have formed and any abnormalities can be detected. The ultrasound can happen as early as 16 weeks, although most wait until around 20 weeks — especially now, since the goal is to have fewer, or more spaced out, in-person visits.

If you haven’t yet had a “real” ultrasound for your baby, this one is legit. In fact, this may be your last ultrasound, provided everything looks good. This “u/s” will typically occur at a perinatal center or at your doctor’s office, and it’s a transabdominal scan (meaning the tech will squeeze sticky gel and run the wand over your belly). The whole show can take up to an hour, so bring some popcorn and your favorite person… just kidding — sadly, you can no longer bring a partner with you. In an effort to prevent the spread of the virus, pregnant women now have to go to their prenatal visits (including for the anatomy scan) on their own to avoid crowding in hospitals and perinatal centers. So make sure to ask for a lot of ultrasound pictures and ask your provider if you can perhaps FaceTime with your partner. Do you want to find out the sex of the baby? You can ask your ultrasound technician to write it down on a piece of paper, sealed in an envelop, for you and your partner to find out together.

The Preparation

Your provider may call you ahead of your visit to make sure that you do not have any symptoms. If you cleared for your in-person visit, you should wear a loose-fitting, two-piece outfit for the anatomy scan ultrasound — and don’t forget your mask! Also, don’t wear a dress, otherwise you’ll have to strip. Only the lower abdominal area needs to be exposed during this procedure.

(Not so) fun fact: A full bladder makes it easier for the US tech to see what’s up, so they may ask you to show up with a full bladder (like it’s not always full anyway – sheesh). Thirty-two ounces is a LOT of water to drink. HOPEFULLY, they will call you back soon and not make you wait in the lobby with that nice, soothing water feature that makes you want to… you may want to wear a panty liner just in case.

Don’t worry though, if you’re swimming into the exam room, notify the technician and he/she can hurry up and do the part-that-requires-a-full bladder, let you go pee, then come back for the rest.

What are they looking for?

Well, a LOT. Here is a short list:

  • determining (or confirming) your baby’s age/due date (although first-tri ultrasounds are MUCH more accurate with due date detection, so if the numbers don’t line up, your doc will almost assuredly go with the date on your earlier scan)
  • measurements of the head, length, and “long bones” to ensure baby is growing properly (and your baby’s face)
  • a survey of all major organs: the four chambers of the heart, both kidneys, the bladder, brain, stomach, spine, and most importantly, the you-know-what! (or NOT). **Be sure to tell your technician up front if you don’t want to know the gender!! (And be advised that EVERYTHING looks like a penis, so don’t jump to conclusions…)
  • the umbilical cord (you should have a three vessel cord: two arteries and one vein)
  • the location of the placenta
  • the fetal heart rate
  • amniotic fluid levels
  • maternal pelvic structures

The technician will also take freeze frames of each of the relevant shots to keep in your baby’s file for future reference. They may also give you a CD or a DVD of the pictures (or an “old-fashioned” swath of print outs!) so you can post scary looking 3D ultrasound pics to Facebook and really creep out all your friends who don’t have babies. MU-hu-hahahaha.

anatomy scan ultrasound
“Is that Venom?”

The most common abnormal finding is the location of the placenta. Most of the time, the placenta gravitates upward in the womb as pregnancy progresses, so that by late pregnancy it’s toward the top of the uterus. But if the embryo implants low in the uterus, the placenta may fully or partially cover the opening of the cervix. This is called placenta previa and occurs in about 1 in 200 pregnancies. A partial previa will usually resolve on its own by 28 weeks, while a complete previa will require a C-section around (or possibly after, depending) 36 weeks (yay modern medicine – if this were 200 years ago, you probably wouldn’t survive).

Placenta Previa anatomy scan ultrasound
 

If there are any problems, you will most likely speak to a perinatologist, an OB who specializes in high-risk pregnancies.

anatomy scan ultrasound

Try to enjoy the show and not dwell on all the scary things they can discover, although that is easier said than done.

Good luck and have fun! P.S. Are you in my posse on Facebook?


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