Questions to Ask at 20-Week Scan
Twenty questions for the twenty-week anatomy scan, covering what is measured, who interprets the images, what the common findings mean, and what happens if part of the scan needs repeating.
The questions
Open any question for the note
Who will be reading this scan, and when will we hear the results?
Why ask it
In many services the sonographer takes the images and a doctor reviews them afterwards, and staff are not always permitted to interpret findings in the room. Knowing this in advance keeps a quiet, careful scan from reading as bad news.
Can you tell me what you're looking at as you go, or would you rather talk at the end?
Why ask it
Asking this early settles the tone. Some sonographers narrate; others need to concentrate on measurements first and will explain afterwards, and a silence that was only concentration is the most common source of unnecessary worry at this appointment.
Is everything you need to see visible today, or will any part need rechecking?
Why ask it
Views can be blocked by the baby's position, the placenta or body habitus, and an incomplete scan is common and usually not a sign of a problem. A rebooking for the remaining views is a routine outcome rather than a warning.
Are the measurements where you'd expect them at twenty weeks?
Why ask it
Growth measurements are compared against a range, not a target, so being at one end of the range is not the same as a concern. If a number sits outside the range, ask whether it changes anything or just gets watched.
How does the placenta look, and where is it sitting?
Why ask it
Position matters mainly for delivery. A placenta lying low at twenty weeks often moves upward as the uterus grows, so the usual answer is a plan to look again later rather than a decision about the birth.
Is the amniotic fluid within the normal range?
Why ask it
Fluid volume is one of the few things at this scan that can prompt closer monitoring on its own. Ask what the number was and what would count as a change worth acting on.
Were you able to see the umbilical cord and check the blood flow?
Why ask it
The cord is checked as part of the survey, including how many vessels it has. Findings here are often noted without any action, so it is worth asking whether something is being recorded for completeness or followed up.
Were you able to see the heart clearly, and is there anything this scan can't show at this stage?
Why ask it
The anatomy scan is a screening test, not a guarantee. Some heart and brain conditions are not visible at twenty weeks, and hearing that plainly now is better than assuming a normal scan has ruled everything out.
Are there any findings you'd describe as soft markers, and what do they mean?
Why ask it
Soft markers are minor variations that raise or lower a statistical likelihood rather than diagnosing anything, and many resolve or turn out to mean nothing. If one is mentioned, ask what it changes in practice before searching for it online.
If something needs a closer look, what happens next and how soon?
Why ask it
Useful to ask even when today's scan is normal, because it tells you the local pathway: a repeat scan, a referral to fetal medicine, a call from a doctor. Knowing the timescale in advance makes any waiting period easier to handle.
Can you tell us the sex, and how certain is that at this point?
Why ask it
Some services decline as policy, and accuracy at twenty weeks is high but not absolute. Say before the scan starts if you would rather not be told, because the survey involves looking either way.
Does anything from today change how the rest of the pregnancy will be monitored?
Why ask it
This turns the scan into a plan. The answer is often that nothing changes, which is worth hearing explicitly, and if extra scans or appointments are added you want to know who arranges them.
Did you look at anything of mine as well, like the cervix or the ovaries?
Why ask it
The survey is mostly about the baby, but cervical length, fibroids and ovarian cysts are sometimes noted at the same visit. Ask whether anything maternal was recorded, because those findings are easy to leave unexplained in the room and then read cold in a letter.
If a finding needed confirming, what further tests would be offered and what do they involve?
Why ask it
Knowing the menu before you need it takes the panic out of a referral. A detailed scan at a fetal medicine unit, a fetal echocardiogram and an amniocentesis carry very different risks and waiting times, and only one of them is invasive.
Do I get a copy of the written report, and who else will see it?
Why ask it
The report uses abbreviations and percentiles that read worse than the conversation did, so it helps to be told what the phrasing means before you read it alone. Ask whether it goes automatically to your midwife and GP or whether you are the one who has to pass it on.
Do today's measurements change my due date, or does the dating scan still stand?
Why ask it
Dates are normally set at the first-trimester scan and not moved at twenty weeks even if the numbers sit slightly off, because early measurements are more reliable for dating. Hearing that explicitly stops a percentile from being mistaken for a new due date.
Does anything from today affect where or how I should plan to give birth?
Why ask it
A low-lying placenta or a finding that needs a paediatric team present can change the unit, the mode of delivery or how early the plan gets made. Usually the answer is that nothing changes yet, which is worth having said out loud before you start reading about birth options.
Are there symptoms that should make me call before my next appointment?
Why ask it
The list is specific rather than general: bleeding, fluid loss, persistent pain, reduced movement once you are feeling it, fever. Ask for the number to call out of hours as well as during the day.
If I think of a question after today, who do I contact?
Why ask it
Most people leave with questions they only formulate later. Getting a named route, a midwife line or a clinic number, saves two weeks of guessing or relying on forums.
When is my next appointment, and what happens at it?
Why ask it
Schedules differ by service and by whether the pregnancy is being monitored more closely. Confirming the date and the purpose before you leave prevents gaps that are hard to fill later.
What to expect at this appointment
Practical guidance for the conversation itself
Practical preparation
Follow the instructions you were given
Advice on eating, drinking and bladder before an anatomy scan varies between services, so use the letter or message you received rather than general advice. Bring your notes or maternity record if you hold one.
Check the policy on guests and children
Many units limit the number of people in the room and do not allow children, partly because the sonographer needs to concentrate and partly because of what a scan sometimes finds. Ask when booking rather than at the door.
Write your questions down and take notes
The scan itself takes most of the appointment, and the discussion at the end can be brief. Two or three written questions and a note of the answers is more reliable than memory afterwards.
What this scan can and cannot do
- It is a screening test. A normal result lowers the likelihood of a range of conditions but does not rule them all out.
- Images can be limited by the baby's position, so a repeat appointment for missing views is common and not in itself concerning.
- Measurements are read against a range for the gestation, so a single number near the edge of the range is often normal.
- Sonographers in many services cannot give a diagnosis; that comes from the doctor who reviews the images.
- Not every finding leads to action. Some are recorded only so a later scan can compare against them.
If a finding is mentioned
Ask for the name of it, written down
Terms spoken in the room are easy to mishear, and searching for a near miss produces frightening and irrelevant results. Ask the person telling you to write the term down before you leave.
Ask what happens next and when
The immediate questions that matter are who is arranging the next step, how long the wait is, and who to call if you do not hear. A clear plan is more use than an explanation you are not ready to absorb yet.
Take someone with you to the follow-up
A second person hears things you will miss and can take notes while you ask questions. If that is not possible, ask whether the discussion can be summarized in writing.