Questions to Ask at 20 Week Ultrasound
Twenty questions for the twenty-week ultrasound, focused on the images being recorded, the report and who reads it, when a referral or repeat scan follows, and who to contact afterwards.
The questions
Open any question for the note
How long will this take, and will I be able to see the screen?
Why ask it
Anatomy scans usually run longer than earlier ones, and in some rooms the screen is angled away while measurements are taken. Knowing that beforehand stops the setup from feeling like something is being kept from you.
Which views are you required to record, and what goes into the report?
Why ask it
The survey follows a checklist: head and brain, spine, heart, abdomen, kidneys, bladder, limbs, placenta, fluid, cord. Asking about the list gives you the shape of the appointment and makes the silences between measurements easier to sit through.
Can I get a copy of the report, and when will it be available?
Why ask it
The report is the record that follows you through the rest of your care, and how you get it varies: an app, a letter, or a request to the clinic. Asking now is easier than chasing it in two weeks.
Are today's images being compared with my earlier scan?
Why ask it
Comparison against the dating scan is what turns single measurements into a growth pattern. If your earlier scan was done elsewhere, this is the moment to check that those records actually reached this clinic.
Are the measurements plotted on a chart I can look at?
Why ask it
Seeing a point on a growth curve is more informative than hearing a number, because it shows how much of the normal range sits either side. It also makes clear that these are population ranges rather than targets.
Does anything today change my due date?
Why ask it
Dating is normally set in the first trimester and rarely revised after it, because the variation between babies grows with gestation. If someone proposes changing it now, ask what specifically justifies the change.
How is the baby's position affecting what you can see today?
Why ask it
A baby facing the spine or lying with limbs across the chest can block views that have nothing wrong with them. The answer tells you whether an incomplete scan today is about anatomy or about geometry.
Was the heart seen well enough to count as complete, or does it need another look?
Why ask it
The heart is the structure most often left for a repeat view, and a rebooking for it is routine. It is also worth hearing plainly that some cardiac conditions are not visible at this stage at all.
Are you looking at my uterus and cervix as well as the baby?
Why ask it
The scan is not only about the baby, and findings such as fibroids or cervical length may be noted. Ask whether anything about your own anatomy was recorded and whether it affects the rest of the pregnancy.
Would a transvaginal view ever be needed at this scan, and would you ask me first?
Why ask it
It is occasionally used when a view cannot be obtained through the abdomen. Establishing consent and the reason before anything starts matters more here than the small chance it comes up.
Is there a limit on how long or how often ultrasound should be used?
Why ask it
Clinical practice keeps exposure to what is needed for the examination rather than extending it for pictures. A clinician who explains that principle is also telling you why a long keepsake session is a different thing from a medical scan.
Can I have printed or digital images, and is there a charge?
Why ask it
Policies differ and some units have stopped providing them. Asking at the start avoids the awkward moment at the end, and tells you whether to expect a card machine.
If I have a scan somewhere else as well, how do the two records fit together?
Why ask it
Private and clinical records do not automatically connect, so a finding from one may never reach the team making decisions about your care. Ask what you would need to bring, and to whom, for it to be counted.
Which findings from today would lead to a referral, and who to?
Why ask it
This maps the pathway before you need it: a repeat scan, a fetal medicine unit, a cardiologist, a genetic counselor. Hearing the routes while everything looks normal is easier than hearing them alongside a concern.
Does anything from today change who leads my care from here?
Why ask it
Care can shift between midwife-led and consultant-led on the basis of a scan. If it does move, ask what practically changes: where you are seen, how often, and whether birth options are affected.
Will I need any more scans, and what would each one be looking for?
Why ask it
Additional scans are common and are not by themselves a bad sign, but they should each have a purpose. A named reason and a booked date are what distinguish monitoring from vague reassurance.
How will I be told if something comes up when the images are reviewed later?
Why ask it
There is usually a gap between the scan and the review, and the failure point is notification. Ask who would contact you, in what timeframe, and what to do if you have heard nothing by then.
What should I know about the baby's movements between now and my next appointment?
Why ask it
Around this stage many people begin to feel movement, and patterns become the thing you are asked about later. The useful part of the answer is what to do if a pattern changes, including who to call outside clinic hours.
Is there anything on the report that looks alarming but is actually routine wording?
Why ask it
Reports contain phrases such as unremarkable, no gross abnormality, or notes of a soft marker, all of which read badly to someone seeing them for the first time. Getting the translation now saves an evening of searching.
Once I've read the report, who do I ask if I have questions?
Why ask it
Most questions arrive after the appointment, not during it. A named contact and a realistic response time is the single most useful thing to leave with, especially if the report contains a term nobody explained.
Working through the appointment
Practical guidance for the conversation itself
Before and during
Use the instructions from your own clinic
Guidance on food, drink and bladder differs between services, so follow the letter or message you were sent instead of general advice. Bring your maternity record if you hold one, along with any earlier scan reports from elsewhere.
Decide in advance about being told the sex
Say what you want at the start, because the survey involves looking either way. If one of you wants to know and the other does not, agree beforehand how that will be handled in the room.
Keep questions for the end unless something worries you
Measurements need concentration, and most sonographers will set aside time afterwards. If something visible on the screen concerns you during the scan, it is reasonable to say so rather than wait.
Reading the report
- Measurements are compared to a range for the gestation. A value near the edge of that range is common and often means nothing on its own.
- Soft markers shift a statistical likelihood rather than diagnose anything, and many resolve or turn out to be normal variation.
- A normal scan lowers risk but does not exclude every condition. Some are not detectable at twenty weeks.
- Unremarkable and no abnormality detected are the phrases you want to see, however blunt they read.
- If a term is unfamiliar, ask the clinic for its meaning before searching, since search results skew heavily toward rare outcomes.
If a repeat scan or referral is arranged
Get the reason in writing
Ask what exactly is being rechecked and why. Repeat appointments for incomplete views are the most common kind, and knowing which type yours is prevents weeks of unnecessary worry.
Confirm who is booking it and by when
Referrals fall through at the handover between departments. Note who is arranging it, the expected timescale, and the number to call if the appointment has not arrived.
Bring someone to the follow-up
A second person retains information you will not. If nobody can come, ask whether the discussion can be summarized in writing or recorded for you.