Should I have an early fetal ultrasound?

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's or certified nurse-midwife's recommendation.

Key points in making your decision

Consider the following as you decide whether to have an early ultrasound, before 20 weeks of pregnancy:

• Fetal ultrasound is a safe and simple way to look at your fetus. If your ultrasound doesn't show any problems, you may feel more reassured and relaxed during your pregnancy.
• If you aren't sure of your last menstrual period, an ultrasound can help confirm the age of the fetus and predict your due date.
• If you have first trimester bleeding, an ultrasound may be able to rule out a miscarriage and reassure you that your fetus is okay.
• Ultrasound may raise concern about a possible problem without necessarily offering a diagnosis. In such a case, you will need to have other tests to confirm ultrasound findings.
• If you are sure of your last menstrual period and don't have any risk factors for birth defects, an ultrasound may not be necessary.

This information may not apply to you if your health professional recommends that you have a fetal ultrasound. Your doctor or nurse-midwife may recommend an ultrasound for a specific medical reason—if there is a need to accurately date your pregnancy, if you are having unusual symptoms, or if you have had abnormal results from another test.

What is a fetal ultrasound?

Fetal ultrasound uses reflected sound waves to provide an image of a fetus and placenta within the uterus. Fetal ultrasound is the safest way to obtain information about the fetus, such as size and position.

A fetal ultrasound can be done as early as the fifth week of pregnancy. During the test, a small handheld instrument called a transducer is used to direct sound waves toward the body. A computer analyzes the sound waves that are reflected back from structures inside the body and converts them into an image. Fetal ultrasound can be done by moving the transducer across the woman's abdomen (transabdominal) or by putting the transducer in her vagina (transvaginal). After about the 11th week of pregnancy, almost all ultrasound tests are done using the transabdominal method.

What information can a fetal ultrasound provide?

An ultrasound done before 20 weeks of pregnancy can give you information about:

• Fetal condition, if vaginal bleeding or other symptoms of miscarriage have raised concern.
• Fetal age and size (sex can often be identified at around 20 weeks of pregnancy).
• The number of fetuses present.
• Some types of birth defects, such as a defect of the spinal cord (neural tube defect), heart, abdominal organs, or brain.
• The condition of the placenta and the amount of amniotic fluid around a fetus.

Ultrasound may raise concern about a possible problem without necessarily offering a definite diagnosis. In such a case, other tests are used to confirm ultrasound findings.

What would I do with information from a fetal ultrasound?

A normal ultrasound does not guarantee a healthy child. However, ultrasound results can give you useful information.

• If your ultrasound doesn't show any fetal problems, you can feel more reassured and relaxed during your pregnancy.
• If you learn that you are carrying more than one fetus, you and your health professional can plan ahead for a healthy pregnancy and delivery. For more information, see the topic Multiple Pregnancy: Twins or More.
• If you find out that the fetus has a problem, you, your partner, and your health professional can discuss your options. The first step may be to repeat the ultrasound or have other tests that can confirm the results.
  • Some problems are treatable soon after the baby is born and may not seriously affect the baby's life. You may be able to plan your delivery in a hospital that offers specialized care for sick newborns.
  • Some defects, such as certain types of neural tube defects and Down syndrome, may not be fatal but will affect the baby for his or her entire life.
  • Rarely, a defect is so severe that the fetus 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 fetus with a severe defect is very personal. Some women who learn that they are carrying a fetus with a serious defect choose the option of ending the pregnancy with a therapeutic abortion. Others make plans for raising a sick or disabled child.

What are the risks of fetal ultrasound?

Fetal ultrasound is a very safe test and does not seem to have any risks. However, an abnormal ultrasound can cause a lot of stress and anxiety. An ultrasound:

• Can show an unusual result that requires more tests, such as another ultrasound or amniocentesis, to confirm. In most cases, these additional tests are normal. However, the additional tests may carry risks. Amniocentesis has more risks than ultrasound, including a very small risk of miscarriage.
• Can show an abnormality that disappears later in the pregnancy.
• May indicate a serious problem when there isn't one. In such a case, additional tests are needed before you can know that there is not a problem. It can be very stressful while you wait for the results.

What are the risks of not having a fetal ultrasound?

If you don't have an ultrasound, there is a slight chance that you may not find out until later in the pregnancy or delivery that:

• You are pregnant with more than one fetus.
• A birth defect is present. Rarely, a fetus has a birth defect that is so serious that the fetus will die later in the pregnancy, during delivery, or soon after birth. Some women would choose to end a severely affected pregnancy rather than suffer a stillbirth or death of a newborn.

For more information, see the topic Fetal Ultrasound.

Your choices are:

• Have a fetal ultrasound.
• Do not have a fetal ultrasound.

The decision about whether to have a fetal ultrasound takes into account your personal feelings and the medical facts.

These personal stories may help you make your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about having a fetal ultrasound. Discuss the worksheet with your health professional.

Circle the answer that best applies to you.

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason for having or not having a fetal ultrasound.

Check the box below that represents your overall impression about your decision.

Return to the topics:

• Fetal Ultrasound
• Pregnancy