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Pregnancy: Should I Have an Early Fetal Ultrasound?

Pregnancy: Should I Have an Early Fetal Ultrasound?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Pregnancy: Should I Have an Early Fetal Ultrasound?

Get the facts

Your options

  • Have an early fetal ultrasound, before 18 to 20 weeks of pregnancy.
  • Don't have an early fetal ultrasound.

Key points to remember

  • Fetal ultrasound is usually done during pregnancy to check the age, size, and position of your baby. Most of the time it is done at about 18 to 20 weeks. If you are sure of your last menstrual period and don't have any risk factors for birth defects, you probably don't need to have this test any earlier.
  • Your doctor may recommend an early ultrasound if there is a need to find out exactly how long you have been pregnant, if you are having unusual symptoms such as bleeding, or if you have had abnormal results from another test.
  • An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health. If that happens, you may need to have other tests to find if there really is a problem.
  • Some "keepsake video" centers sell ultrasound videos as your baby's first photo. But these centers may use the ultrasound machine at a higher energy level and for longer times than is safe. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.
FAQs

What is a fetal ultrasound?

Fetal ultrasound uses sound waves to make pictures of the fetus and placenta inside the uterus. The test is the safest way to find out the age, size, and position of your baby. During the test, a small handheld device called a transducer is passed over your belly. If ultrasound is done before the 11th week of pregnancy, a transducer shaped to fit inside your vagina may be used.

Fetal ultrasound is usually done at about 18 to 20 weeks of pregnancy. If you are sure of your last menstrual period and don't have any risk factors for birth defects, you probably don't need to have this test any earlier.

A combination of tests that includes ultrasound may be done during your first trimester to check for Down syndrome . This first-trimester screening test is different from the routine ultrasound that is usually done at about 18 weeks of pregnancy. It uses an ultrasound measurement of the thickness of the skin at the back of the baby's neck (nuchal translucency).

How is information from an early fetal ultrasound used?

If your doctor recommends that you have an early fetal ultrasound (before 18 to 20 weeks), the test may give you some useful information.

  • If the test doesn't show any problems, you may feel more at ease during your pregnancy.
  • If you learn that you are carrying more than one baby, you and your doctor can plan ahead for a healthy pregnancy and delivery.
  • If you find out that the baby has a problem, then you, your partner, and your doctor can talk about your choices. The first step may be to repeat the ultrasound or have other tests to confirm the results.
    • Some problems can be treated soon after the baby is born. They may not seriously affect your baby's life. You may be able to plan your delivery in a hospital that offers special care for sick newborns.
    • Some problems, such as certain types of neural tube defects and Down syndrome, may not be fatal. But they will affect your baby for his or her entire life.
    • In rare cases a defect is so severe that the baby may not survive the pregnancy or may die soon after birth.
    • Sometimes a possible defect is suspected but not confirmed, and the baby is born perfectly healthy.

The decision about what to do if you find out that you are carrying a baby with a severe defect is very personal. Some women who learn that their baby has a serious defect choose to end their pregnancy. Others make plans for raising a sick or disabled child.

What are the risks of an early fetal ultrasound?

Fetal ultrasound is a safe test when it's performed for medical reasons by a trained ultrasound technologist or a doctor. 1

Abnormal results from an early fetal ultrasound can cause a lot of stress and anxiety. For example:

  • They can require more tests to find out if there really is a problem. You might need another ultrasound or amniocentesis . Most of the time, the results from these extra tests are normal. But extra tests can carry risks. Amniocentesis has more risks than ultrasound, including a very small risk of miscarriage.
  • They can show a problem that goes away later in your pregnancy.
  • They may show a serious problem when there isn't one. But you may need more tests before you know this for sure. It can be stressful while you wait to find out.

Some "keepsake video" centers sell ultrasound videos as your baby's first photo. But these centers may use the ultrasound machine at a higher energy level and for longer times than is safe. The U.S. Food and Drug Administration advises against getting a fetal ultrasound unless there is a medical reason.

What are the risks of not having an early fetal ultrasound?

If you don't have an early ultrasound, there is a slight chance that you may not find out until later that:

  • You are carrying more than one baby.
  • Your baby has a birth defect. In rare cases, a defect is so severe that the baby may not survive the pregnancy or may die soon after birth. Some women choose to end a pregnancy rather than suffer a stillbirth or death of a newborn.

Why might your doctor recommend an early fetal ultrasound?

Your doctor may recommend an early ultrasound if:

  • You have bleeding or other symptoms of miscarriage.
  • You have risk factors for birth defects. An ultrasound can check for birth defects that affect the baby's brain and spinal cord.
  • There is a need to find out exactly how long you have been pregnant.
  • You have had another test that suggests a possible problem with the fetus.

Compare your options

Compare

What is usually involved?









What are the benefits?









What are the risks and side effects?









Have early fetal ultrasound Have early fetal ultrasound
  • Fetal ultrasound is usually done by an ultrasound technologist or doctor in a doctor's office, hospital, or clinic. An early fetal ultrasound is one that is done before 18 to 20 weeks of pregnancy.
  • The test takes 15 to 60 minutes.
  • If the test doesn't show any problems, you may feel more at ease during your pregnancy.
  • If the test shows that you are carrying more than one baby, you can plan ahead for a healthy pregnancy and delivery.
  • If you find out that your baby has a problem, you can discuss your options with your partner and doctor.
  • The test can create a lot of stress and anxiety. For example, ultrasound may show a problem that goes away later in your pregnancy.
  • You may need more tests, such as amniocentesis, to rule out or confirm a problem seen with ultrasound.
  • Some "keepsake video" centers may not use ultrasound at levels that are safe for your baby. You shouldn't have a fetal ultrasound unless there is a medical reason.
Don't have early fetal ultrasound Don't have early fetal ultrasound
  • You wait until 18 to 20 weeks of pregnancy to have a routine ultrasound exam to check the age, size, and position of your baby.
  • You avoid the stress and anxiety of an early fetal ultrasound.
  • You don't need extra tests to find out if there really is a problem that may not be serious or that goes away later in your pregnancy.
  • You may not find out until later in your pregnancy that:
    • You are carrying more than one baby.
    • Your baby has a birth defect.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about early fetal ultrasound

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Raoul and I talked for a long time about this pregnancy and what having a baby would mean to us. For personal reasons, we would not choose to end the pregnancy if there was a problem with the baby. So we decided not to do any prenatal diagnostic tests unless something goes wrong. We trust that whether the baby is perfect or not, it will be the baby (or babies!) that we are meant to have. Our families think that our approach is a little unusual, but we are both comfortable with our decision.

Rita, age 24

I guess that you could call me a bit of a worrywart. I just know that I will feel better if I can actually see the baby on the monitor and see its little heart beating and have that one more bit of information to reassure me that everything is okay.

Rachel, age 33

My sister had a healthy baby boy last spring after spending most of her pregnancy worrying that everything was not okay with the baby. She had an ultrasound that showed a cyst in the baby's brain. The cyst went away, and her doctor said that they are really common and almost never cause a problem, but the whole experience was really stressful for her and her husband. At one point they even wondered if they should end the pregnancy. So now that I'm pregnant, I feel torn. If there is a problem, I think I would want to know, but a false alarm would be so stressful! I think the worry would be worse for me and the baby than any problem.

Melissa, age 32

I read a lot about prenatal testing, including ultrasound, so I know what it can and can't show about the baby. My doctor says that because of my age and our family histories, there is very little chance that there are any problems with the baby (although we understand that no one can ever be sure about this). So I know there really isn't any reason to have the ultrasound ... but this is the only child we plan to have, and I want to have the whole pregnancy experience, ultrasound and all.

Julie, age 25

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have an early fetal ultrasound

Reasons not to have an early fetal ultrasound

I need to know exactly how long I've been pregnant.

I already know how long I've been pregnant.

More important
Equally important
More important

I want to find out now if my baby has any birth defects.

I don't need to know right now if my baby has birth defects.

More important
Equally important
More important

I'm worried about some of my pregnancy symptoms, like bleeding.

I don't have any unusual symptoms.

More important
Equally important
More important

I want to have an early picture of my baby to show my friends and family.

I don't want to have a test I don't need.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having an early fetal ultrasound

NOT having an early fetal ultrasound

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1.

If you're curious about what your baby looks like, is it okay to get an early fetal ultrasound?

  • Yes Sorry, that's not right. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.
  • No You're right. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.
  • I'm not sure It may help to go back and read "What are the risks of an early fetal ultrasound?" The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.
2.

Are bleeding or abnormal results from another test reasons to have an early fetal ultrasound?

  • Yes You're right. Your doctor may recommend an early ultrasound if you are having bleeding or if you have abnormal results from another test.
  • No Sorry, that's not right. Your doctor may recommend an early ultrasound if you are having bleeding or if you have abnormal results from another test.
  • I'm not sure It may help to go back and read "Why might your doctor recommend an early fetal ultrasound?" Bleeding and abnormal test results are two reasons for having an early ultrasound.
3.

If a problem is seen on early ultrasound, can you be sure it is serious and important?

  • Yes Sorry, that's not right. An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.
  • No You're right. An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.
  • I'm not sure It may help to go back and read "What are the risks of an early fetal ultrasound?" An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.

Decide what's next

1.

Do you understand the options available to you?

2.

Are you clear about which benefits and side effects matter most to you?

3.

Do you have enough support and advice from others to make a choice?

Certainty

1.

How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure
3.

Use the following space to list questions, concerns, and next steps.

Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision  

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts  

Key concepts that you understood

Key concepts that may need review

Getting ready to act  

Patient choices

Credits and References

Credits
Credits Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer William Gilbert, MD - Maternal and Fetal Medicine

References
Citations
  1. American Institute of Ultrasound in Medicine (2007). AIUM practice guideline for the performance of obstetric ultrasound examinations. Available online: http://www.aium.org/publications/guidelines.aspx.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Pregnancy: Should I Have an Early Fetal Ultrasound?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have an early fetal ultrasound, before 18 to 20 weeks of pregnancy.
  • Don't have an early fetal ultrasound.

Key points to remember

  • Fetal ultrasound is usually done during pregnancy to check the age, size, and position of your baby. Most of the time it is done at about 18 to 20 weeks. If you are sure of your last menstrual period and don't have any risk factors for birth defects, you probably don't need to have this test any earlier.
  • Your doctor may recommend an early ultrasound if there is a need to find out exactly how long you have been pregnant, if you are having unusual symptoms such as bleeding, or if you have had abnormal results from another test.
  • An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health. If that happens, you may need to have other tests to find if there really is a problem.
  • Some "keepsake video" centers sell ultrasound videos as your baby's first photo. But these centers may use the ultrasound machine at a higher energy level and for longer times than is safe. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.
FAQs

What is a fetal ultrasound?

Fetal ultrasound uses sound waves to make pictures of the fetus and placenta inside the uterus. The test is the safest way to find out the age, size, and position of your baby. During the test, a small handheld device called a transducer is passed over your belly. If ultrasound is done before the 11th week of pregnancy, a transducer shaped to fit inside your vagina may be used.

Fetal ultrasound is usually done at about 18 to 20 weeks of pregnancy. If you are sure of your last menstrual period and don't have any risk factors for birth defects, you probably don't need to have this test any earlier.

A combination of tests that includes ultrasound may be done during your first trimester to check for Down syndrome . This first-trimester screening test is different from the routine ultrasound that is usually done at about 18 weeks of pregnancy. It uses an ultrasound measurement of the thickness of the skin at the back of the baby's neck (nuchal translucency).

How is information from an early fetal ultrasound used?

If your doctor recommends that you have an early fetal ultrasound (before 18 to 20 weeks), the test may give you some useful information.

  • If the test doesn't show any problems, you may feel more at ease during your pregnancy.
  • If you learn that you are carrying more than one baby, you and your doctor can plan ahead for a healthy pregnancy and delivery.
  • If you find out that the baby has a problem, then you, your partner, and your doctor can talk about your choices. The first step may be to repeat the ultrasound or have other tests to confirm the results.
    • Some problems can be treated soon after the baby is born. They may not seriously affect your baby's life. You may be able to plan your delivery in a hospital that offers special care for sick newborns.
    • Some problems, such as certain types of neural tube defects and Down syndrome, may not be fatal. But they will affect your baby for his or her entire life.
    • In rare cases a defect is so severe that the baby may not survive the pregnancy or may die soon after birth.
    • Sometimes a possible defect is suspected but not confirmed, and the baby is born perfectly healthy.

The decision about what to do if you find out that you are carrying a baby with a severe defect is very personal. Some women who learn that their baby has a serious defect choose to end their pregnancy. Others make plans for raising a sick or disabled child.

What are the risks of an early fetal ultrasound?

Fetal ultrasound is a safe test when it's performed for medical reasons by a trained ultrasound technologist or a doctor. 1

Abnormal results from an early fetal ultrasound can cause a lot of stress and anxiety. For example:

  • They can require more tests to find out if there really is a problem. You might need another ultrasound or amniocentesis . Most of the time, the results from these extra tests are normal. But extra tests can carry risks. Amniocentesis has more risks than ultrasound, including a very small risk of miscarriage.
  • They can show a problem that goes away later in your pregnancy.
  • They may show a serious problem when there isn't one. But you may need more tests before you know this for sure. It can be stressful while you wait to find out.

Some "keepsake video" centers sell ultrasound videos as your baby's first photo. But these centers may use the ultrasound machine at a higher energy level and for longer times than is safe. The U.S. Food and Drug Administration advises against getting a fetal ultrasound unless there is a medical reason.

What are the risks of not having an early fetal ultrasound?

If you don't have an early ultrasound, there is a slight chance that you may not find out until later that:

  • You are carrying more than one baby.
  • Your baby has a birth defect. In rare cases, a defect is so severe that the baby may not survive the pregnancy or may die soon after birth. Some women choose to end a pregnancy rather than suffer a stillbirth or death of a newborn.

Why might your doctor recommend an early fetal ultrasound?

Your doctor may recommend an early ultrasound if:

  • You have bleeding or other symptoms of miscarriage.
  • You have risk factors for birth defects. An ultrasound can check for birth defects that affect the baby's brain and spinal cord.
  • There is a need to find out exactly how long you have been pregnant.
  • You have had another test that suggests a possible problem with the fetus.

2. Compare your options

  Have early fetal ultrasound Don't have early fetal ultrasound
What is usually involved?
  • Fetal ultrasound is usually done by an ultrasound technologist or doctor in a doctor's office, hospital, or clinic. An early fetal ultrasound is one that is done before 18 to 20 weeks of pregnancy.
  • The test takes 15 to 60 minutes.
  • You wait until 18 to 20 weeks of pregnancy to have a routine ultrasound exam to check the age, size, and position of your baby.
What are the benefits?
  • If the test doesn't show any problems, you may feel more at ease during your pregnancy.
  • If the test shows that you are carrying more than one baby, you can plan ahead for a healthy pregnancy and delivery.
  • If you find out that your baby has a problem, you can discuss your options with your partner and doctor.
  • You avoid the stress and anxiety of an early fetal ultrasound.
  • You don't need extra tests to find out if there really is a problem that may not be serious or that goes away later in your pregnancy.
What are the risks and side effects?
  • The test can create a lot of stress and anxiety. For example, ultrasound may show a problem that goes away later in your pregnancy.
  • You may need more tests, such as amniocentesis, to rule out or confirm a problem seen with ultrasound.
  • Some "keepsake video" centers may not use ultrasound at levels that are safe for your baby. You shouldn't have a fetal ultrasound unless there is a medical reason.
  • You may not find out until later in your pregnancy that:
    • You are carrying more than one baby.
    • Your baby has a birth defect.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.

Personal stories about early fetal ultrasound

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"Raoul and I talked for a long time about this pregnancy and what having a baby would mean to us. For personal reasons, we would not choose to end the pregnancy if there was a problem with the baby. So we decided not to do any prenatal diagnostic tests unless something goes wrong. We trust that whether the baby is perfect or not, it will be the baby (or babies!) that we are meant to have. Our families think that our approach is a little unusual, but we are both comfortable with our decision."

— Rita, age 24

"I guess that you could call me a bit of a worrywart. I just know that I will feel better if I can actually see the baby on the monitor and see its little heart beating and have that one more bit of information to reassure me that everything is okay."

— Rachel, age 33

"My sister had a healthy baby boy last spring after spending most of her pregnancy worrying that everything was not okay with the baby. She had an ultrasound that showed a cyst in the baby's brain. The cyst went away, and her doctor said that they are really common and almost never cause a problem, but the whole experience was really stressful for her and her husband. At one point they even wondered if they should end the pregnancy. So now that I'm pregnant, I feel torn. If there is a problem, I think I would want to know, but a false alarm would be so stressful! I think the worry would be worse for me and the baby than any problem."

— Melissa, age 32

"I read a lot about prenatal testing, including ultrasound, so I know what it can and can't show about the baby. My doctor says that because of my age and our family histories, there is very little chance that there are any problems with the baby (although we understand that no one can ever be sure about this). So I know there really isn't any reason to have the ultrasound ... but this is the only child we plan to have, and I want to have the whole pregnancy experience, ultrasound and all."

— Julie, age 25

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have an early fetal ultrasound

Reasons not to have an early fetal ultrasound

I need to know exactly how long I've been pregnant.

I already know how long I've been pregnant.

             
More important
Equally important
More important

I want to find out now if my baby has any birth defects.

I don't need to know right now if my baby has birth defects.

             
More important
Equally important
More important

I'm worried about some of my pregnancy symptoms, like bleeding.

I don't have any unusual symptoms.

             
More important
Equally important
More important

I want to have an early picture of my baby to show my friends and family.

I don't want to have a test I don't need.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having an early fetal ultrasound

NOT having an early fetal ultrasound

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1. If you're curious about what your baby looks like, is it okay to get an early fetal ultrasound?

  • Yes
  • No
  • I'm not sure
You're right. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.

2. Are bleeding or abnormal results from another test reasons to have an early fetal ultrasound?

  • Yes
  • No
  • I'm not sure
You're right. Your doctor may recommend an early ultrasound if you are having bleeding or if you have abnormal results from another test.

3. If a problem is seen on early ultrasound, can you be sure it is serious and important?

  • Yes
  • No
  • I'm not sure
You're right. An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.

Decide what's next

1. Do you understand the options available to you?

2. Are you clear about which benefits and side effects matter most to you?

3. Do you have enough support and advice from others to make a choice?

Certainty

1. How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2. Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

3. Use the following space to list questions, concerns, and next steps.

 
Credits
By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer William Gilbert, MD - Maternal and Fetal Medicine

References
Citations
  1. American Institute of Ultrasound in Medicine (2007). AIUM practice guideline for the performance of obstetric ultrasound examinations. Available online: http://www.aium.org/publications/guidelines.aspx.

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