The Magic Of The 20 Week Scan

In the days leading up to the scan my wife or Rambo* as she will be known from here on in had a car accident. Another driver drove in to the back of her. I won’t bore you with the details of the accident but we spent an agonising evening in the hospital having Rambo’s back/neck checked and ensuring the baby was ok. Unfortunately, the doctor said during the triage that all he could/would do was an ultrasound in order to check for a heartbeat.

When you are in that situation, worried for your unborn child, you have doubts as to whether what the doctor says is satisfactory. Would a heartbeat tell you everything was ok? How would you know if the accident had done any damage to baby? To be blunt, you question the doctors credentials – I almost asked for a Cv stating relevant experience in dealing with unborn babies.

During the ultrasound the doctor stopped in mid-sentence (not that he was saying anything of interest, more observational commentary to himself, “There’s the bladder…” etc) and began to look worried.

I didn’t really understand what was going on but Rambo and I both knew something was wrong.

We endured the silence and held our breathe, until what appeared to be a little arm moved slightly and the doctor starting talking again. I guess he worried about the lack of movement.

In reality it was a few seconds of heart in mouth torment but seemed like an eternity.

We left the hospital that night, Rambo bruised and me slightly shaken with a sense of uncertainty. The baby had a heart beat and had moved but we didn’t know if everything was ok. Luckily for us we had our 20 week scan a few days later.

Swiftly moving forward a few days…..

The big day was upon us… the 20 week scan had arrived.

We drove down to the hospital in silence, no jibber jabber, no radio, just silence. The tension was unbearable, we were both so worried about the what may or may not be revealed from the scan.

The 12 week scan had been a defining moment in the pregnancy for me. It was a reality check. I could physically see the baby. It wasn’t just something inside of Rambo’s stomach that was making her very sick, it was on screen and very very real.

Once in the hospital, we sat in the waiting area, surrounded by old ladies… I’m not 100% sure what they were there for, I assumed not pregnancy scans! I started looking at each one and creating scenarios in my head as to why they were there. Childish I know but it helped ease my nerves:

Doris sat to the right of me – Broken arm in an arm wrestling competition

Betty sat in the corner reading a magazine – Suspected fracture of the leg whilst repointing the chimney on her neighbours house

Ethel sat in front of me smiling – Torn ligament in her wrist from break dancing in preparation for Britain’s Got Talent.

I was gratefully interrupted in my thoughts by the dullest sounding voice I had ever heard:

“Mrs Rambo, Is there a Mrs Rambo”. We were up, the moment of truth was upon us.

We got in the room and the pleasantries began. Name, DOB, Blah Blah.

The cold gel on and ultrasound about to commence….. and my bloody phone went off! It was work dialling me in for a meeting. What flaming timing!

The scan lady (not really sure what her title is) pointed me towards the door with her eyes as I answered the phone.

I rushed out and managed to get out of the call and rushed back in.

The baby was in an awkward position so Rambo had to get up and jump about until the baby was in a scan friendly position.

Watching the ultrasound was beautiful. My baby was on screen, I could see it again.

The baby was wriggling about and I could not help grinning in admiration of mother and child. I was already a proud father! Wasn’t my baby brilliant, it could move its hands and feet! (I do know they all do that, don’t steal my moment!)

The ultrasound itself is not just a general glance around like the 12 week scan, it’s a thorough check. They check all the organs and limbs.

The scan lady, kept saying “good” as she inspected the legs, arms, head, brain, spine, kidney, heart….

It was such a relief to hear reassuring words about the baby especially given our additional worry from the accident.

Another major development was that we were told we were having a girl.

Once the texts to our parents were done, we walked hand in hand down the corridor back to our car. For the second time that day, we sat in silence on the drive home. This time gleaming with joy and excitement. What a wonderful day.


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*(A friend told me to stop referring to her as my wife in the blog and give her a name. Rambo seems appropriate. I can’t go in to why as I fear ‘Rambo’ may draw ‘First Blood’)

 If you wondered what they actually check for on the scan then the following extract may be useful:

What will the sonographer look at on my scan?

The sonographer will examine all your baby’s organs and take measurements (FASP 2010). She will look at:

  • The shape and structure of your baby’s head. At this stage severe brain problems, which happen very rarely, are visible.
  • Your baby’s face, to check for a cleft lip. Cleft palates inside a baby’s mouth are hard to see and are not often picked up.
  • Your baby’s spine, both along its length, and in cross section, to make sure that all the bones align, and that the skin covers the spine at the back.
  • Your baby’s abdominal wall, to make sure it covers all the internal organs at the front, as well as check the placenta, umbilical cord and the amniotic fluid (FASP 2012b).
  • Your baby’s heart. The top two chambers (atria) and the bottom two chambers (ventricles) should be equal in size. The valves should open and close with each heartbeat. Your sonographer will also examine the major veins and arteries which carry blood to and from your baby’s heart (FASP 2012a).
  • Your baby’s stomach. Your baby swallows some of the amniotic fluid that he lies in, which is seen in his stomach as a black bubble.
  • Your baby’s kidneys. The sonographer will check that your baby has two kidneys, and that urine flows freely into his bladder. If your baby’s bladder is empty, it should fill up during the scan and be easy to see. Your baby has been doing a wee every half an hour or so for some months now!
  • Your baby’s arms, legs, hands and feet. The sonographer will look at your baby’s fingers and toes, but not count them.

The placenta may be on the front wall (anterior) or the back wall of your uterus (posterior), usually near the top (or fundus). If the placenta is near the top, it may be described as fundal on your scan notes. The placenta will be described as low if it reaches down to or covers the neck of your uterus (your cervix). If the placenta is lying low in your uterus, you’ll have another scan in the third trimester to check its position. By then, it’s likely the placenta will have moved away from your cervix. It is possible to count the three blood vessels (two arteries and a single vein) in the umbilical cord, but your sonographer may not do this. It’s not routine procedure. She will check to see that’s there’s enough amniotic fluid for your baby to move freely, though. During the scan, the sonographer will measure parts of your baby’s body, to see how well he is growing. The sonographer will measure your baby’s:

  • head circumference (HC)
  • abdominal circumference (AC)
  • thigh bone (femur) (FL)

The measurements should match up to what’s expected for your baby, depending on when his due date is. The due date will have been established at your dating scan. If your anomaly scan is the first scan you’ve had, it will be used to establish a due date.

Which abnormalities can be seen on the scan?

Sonographers have a list of conditions to look out for. The conditions are either very serious, which may mean that a baby can’t survive, or they may be treatable conditions, once your baby is born. If the condition is treatable, it will help the hospital team to know in advance, so they can make sure your baby has the right care as soon as he’s born. Some conditions are easier to spot than others, and some are hard to see at all. Most of the conditions on the list are very rare. Here’s the list of conditions, and the percentage chance of your sonographer seeing each one, if your baby has it:

  • absence of the top of the head (anencephaly): 98 per cent
  • cleft lip: 75 per cent
  • defect of the abdominal wall, where the bowel and liver protrude (exomphalos): 80 per cent
  • defect of the abdominal wall, where the intestines protrude (gastroschisis): 98 per cent
  • missing or very short limbs: 90 per cent
  • defect of the spinal cord (spina bifida): 90 per cent
  • major kidney problems (missing or abnormal kidneys): 84 per cent
  • hole in the muscle separating chest and abdomen (diaphragmatic hernia): 60 per cent
  • excess fluid within the brain (hydrocephalus): 60 per cent
  • Edwards’ syndrome or Patau’s syndrome (chromosomal abnormalities): 95 per cent
  • major heart problems (defects of chambers, valves or vessels): 50 per cent

Some conditions, including heart defects and bowel obstructions, may not be seen until later in your pregnancy. Having an anomaly scan will most likely rule out all these conditions, as the vast majority of babies are born healthy.

9 thoughts on “The Magic Of The 20 Week Scan

  1. Congrats on the girl-news! I imagine a girl would be fun, I have six boys, so I wouldn’t really know. Also, it’s nice to see a dad’s perspective, and nice to see a dad getting all excited about it! I know my hubby was, too, but he’s not a very outwardly emotional guy.

    Liked by 1 person

  2. Having gone through this same scan just over a month ago – I’m pretty sure my Husband did the exact same thought processes as you! Glad that Rambo and Baby Rambo are all well and good! Congrats on having a little girl!

    Liked by 1 person

  3. What a lovely post, this made me cry a little as it brought back how worried I was before our 20 week scan – I can’t even imagine what you guys must have been feeling factoring in the accident too. So glad all was okay, and congratulations on a little girl! How exciting!

    Liked by 1 person

  4. Ahhh, just read your 20 week scan blog after we had our scan this morning! Like others have said, SO lovely to hear from Dad! Hope your little girl is still growing away nicely in there and ready to make her expected arrival next month! You know, I’ve heard of several women having car accidents whilst pregnant – I think it’s scarily common but glad everything was okay. Tense, horrible time for you both!

    She’ll soon be here! LPMx

    Liked by 1 person

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