Ultrasound scans
Maternity Scans:
One adult is allowed to accompany you in the scan room.
As part of your antenatal care, you will be offered various tests to check on the health of your developing baby and for conditions that may affect you or your baby. It is important you book for antenatal care as early as possible in your pregnancy. This will help you get these tests at the appropriate time, and benefit from other care for you and your baby.
When are Scans Offered?
There are 2 routine ultrasound scans offered in England:
- Nuchal Dating Scan - 11+2 -14+1 scans
- Anomaly Scan – 18-20+6 weeks
Screening tests are used to find people at higher chance of having a health problem. This means they can get earlier, potentially more effective treatment, or make informed decisions about their health. It can be helpful to imagine screening like putting people through a sieve. Most people pass straight through but a small number get caught in the sieve. The people caught in the sieve are those considered to have a higher chance of having the health problem being screened for.
Screening tests are not perfect. Some people will be told that they or their baby have a high chance of having a health problem when in fact they do not have the problem. Also, a few people will be told that they or their baby have a low chance of having a health problem when in fact they do have the problem.
First Trimester
During the first appointment with the midwife, you will be offered several tests. The tests are to check for different conditions that may affect you or your baby. The results of these tests are given at a future appointment; however, you may well be contacted earlier if a result requires some action. These tests include hepatitis and HIV.
You can choose to have a screening test for chromosomal abnormalities when you attend for your screening and ultrasound scan visit (between 11+2 and 14+1 weeks of pregnancy).
The blood test measures the amount of two proteins PAPPA and FREE BETA HCG. These proteins appear naturally in your blood during pregnancy. A change in the level of these proteins can indicate an increased chance of abnormality, but doesn't give you a certain diagnosis.
The ultrasound uses sound waves to make a picture of your baby on a screen. It can show the age and position of your baby, and also if there is more than one baby. During the scan, the ultra-sonographer will also measure the amount of fluid behind the neck of the baby - this test is called the nuchal translucency. This measurement, along with the baby’s age, your age, and the results of the biochemical tests will allow us to calculate the individual risk of the baby having a chromosomal abnormality such as Down’s syndrome. If the risk is increased, you will be offered the opportunity to discuss further with the doctor or midwife.
If it is considered appropriate for further follow up tests, the appropriate diagnostic tests will either be chorionic villus sampling (CVS) where a small amount of afterbirth is tested under ultrasound, or amniocentesis where a small amount of fluid from around the baby is tested.
Sickle cell and thalassaemia (SCD): screening in pregnancy for SCD and thalassaemia involves having a blood test. It is best to have the test ideally by eight weeks, to allow for your results to appear on your electronic medical records by 10 weeks. This test is offered to all women cared for through our Trust.
The screening will find out if you are a carrier of the sickle cell or thalassaemia gene and therefore likely to pass it on to the baby.
Second Trimester Screening
If you book after 13 weeks and 6 days, you can still have a blood test. This test is called the Quad test and includes four markers: Free-beta HCG, AFP, Unconjugated Estriol and Inhibin-A. It will detect around 80% of Down’s syndrome cases.
Read more about Quad Tests - Screening tests for you and your baby.
Screening tests during pregnancy
Anomaly Scan:
The Anomaly scan is conducted between 18 and 20+6 weeks' gestation and are a key component of routine prenatal care . The purpose of the anomaly scan is to check the physical development of the baby.
The patients should be aware that structural defects and chromosomal abnormalities (particularly brain and heart abnormalities) cannot be completely excluded by ultrasound scan alone.
We may not always be able to finish all the necessary checks in one scan appointment due to baby’s position, high maternal BMI etc. The sonographer may ask you to come back for a repeat anomaly scan to finish the checks later.
Growth Scans:
Growths scans are performed later in the pregnancy (usually after 28 weeks) to assess your baby's growth. These scans are not done routinely and will only be performed at a doctor's request.
Can I find out the gender of my baby?
If you would like to find out the sex of your baby, you can do so at the anomaly scan. Please inform the sonographer at the start of the scan. Please bear in mind that the ultrasound examination is to look for structural abnormalities with the baby and checking the sex of the baby is not the primary purpose of the scan. Please note, the sonographer could not be 100% certain of baby's sex and will only verbally inform you. At times, the sonographer may not be able to see the sex of baby, e.g. if the position of baby does not allow. We do not offer rescans for fetal gender as this is not part of the anomaly scan.
What to Expect During Your Scan Appointment?
Most scans are performed by male or female sonographers.
Please note, we have both male and female staff working in the ultrasound department.
Requests to have a preferred gender of staff will be considered, however the Trust has no obligation to fulfil such requests if resources do not permit (NHS Act 1990). Please contact the ultrasound scan department ahead of your appointment. Although every effort will be made to accommodate the request this can change on the day of your scan due to service needs which are out of the department's control. Our primary aim will always be to provide a high standard of care, regardless of the sex of the clinician.
The scan is usually carried out in dimly lit room for the sonographer to obtain good images of your baby. The sonographer/support worker will also confirm your ID and explain the scan procedure.
You will be asked to lie on the patient couch and reveal your abdomen and cold gel will be applied to your tummy. The sonographer uses a transducer (also known as a probe) to obtain pictures which will appear on the ultrasound machine screen. The sonographer may need to apply slight pressure on your abdomen to get the best views possible of the baby.
During your scan, the sonographer may be quiet , please do not worry, this is to allow the sonographer to concentrate on checking the baby carefully. There is patient monitor for you to see the baby as the sonographer is scanning.
Can I Have a Picture of My Baby?
If you would like to purchase a picture, please inform the sonographer at the start of your scan.
How long will the scan take?
Usually, the scan takes about 20-30 minutes. At times, the scan may take longer depending on baby/babies’ position. If the sonographer is not able to obtain all the necessary images, the scan may need to be repeated on a different day.
Can Anyone Come With Me For My Scan?
We do appreciate that this a special time for you and your family, however all scans require a lot of concentration from the sonographer. Distraction from multiple people may cause important findings to be missed during the scan, therefore we request that you do not bring more than one person to the hospital.
Do you have Trainees in the Department?
Yes, The Trust is a teaching hospital and training in the ultrasound department is supported. A trainee sonographer is a qualified radiographer, specializing in Ultrasound. A trainee may undertake your examination, however will be supervised at all times. You can decline a trainee performing your scan if you wish.
Please note , the ultrasound scan is an important medical examination, and it is to be treated the same way as any other hospital investigation.
Patients and visitors to the Trust are reminded that verbal and / or physical abuse to Trust staff, other patients or visitors will not be tolerated