
Fetal Anatomy Scan
The fetal anatomy scan is a comprehensive and highly specialized ultrasound examination of all major fetal organs and systems.
The information gathered in the course of the examination is directly related to the gestational age at the time of scanning, i.e. the fetal anatomy assessment may not be feasible or complete if the pregnancy is not at the recommended gestational window.
The scan is performed by qualified healthcare professionals with a high-end ultrasound equipment. The experience of the examiner is of utmost importance.
The major objective of the fetal anatomy scan is to provide reassurance that the pregnancy is developing normally. However, specific problems or complications can be diagnosed and further investigation may be required in selected cases. Thus, all the information gathered by the course of scanning can help the prospective parents to make an informed decision.
The fetal anatomy scan is mainly performed by 2D ultrasound. 3D imaging or recording of 4D video clips is possible in most cases and is always performed if the circumstances allow it. However, it is important to emphasize that this is not the main objective of the scan.

The ultrasound assessment of the fetal anatomy is normally performed in every trimester of pregnancy - the first (at 12-13+6 weeks of gestation), the second (at 18-23 w.g.) and the third (at 28-32 w.g.) trimester. Each of these scans has its own specific characteristics. The examination can be carried out in other gestational periods if necessary.
The fetal anatomy scan at 12-13+6 weeks of gestation (optimally at 12+0-13+6 w.g.) is usually performed transabdominally. Ocasionally, a transvaginal approach is preferred, mainly when better visualization is required (suspicion of a structural abnormality, overweight patients, etc.).
The main indications for fetal anatomy assessment at 12+0-13+6 w.g. at MC MARKOVS are:
- To perform fetal biometry, to confirm the gestational age and to calculate the estimated date of delivery (EDD);
- To evaluate all major fetal organs and systems and to exclude these structural defects that are feasible for assessment;
- To assess the risk for associated fetal chromosomal abnormalities by evaluation of a number of important ultrasound markers;
- To perform ultrasound screening for preeclampsia and fetal growth restriction by Doppler evaluation the blood flow in the uterine arteries;
- To plan additional tests such as combined (biochemical) screening, NIPT, chorionic villus sampling, etc.
Attention: Due to the relatively small fetal size at 12-13+6 w.g. and the subsequent rapid development the fetal anatomy scan is usually repeated later in gestation.
The fetal anatomy scan at 18-23 weeks of gestation (optimally at 20-22 w.g.) is the second important ultrasound examination in pregnancy. It allows a detailed assessment of all fetal organs and systems, including the fetal heart (fetal echocardiography), brain, spine, face, limbs, etc.
- The assessment of the fetal heart, spine and face can be challenging in early pregnancy. In addition, the central nervous system develops rapidly throughout gestation;
- Consequently, the most important ultrasound evaluation of the fetal anatomy is usually planned in the second trimester (20-23 w.g.) The vast majority of fetal structural abnormalities can be diagnosed or excluded during that particular scan;
- Furthermore, ultrasound screening for chromosomal abnormalities, as well as ultrasound screening for premature delivery by measuring the cervical length, is also performed;
- Doppler examination of the blood flow between the mother and the fetus can also be carried out.
Attention: In overweight patients the second trimester fetal anatomy scan should be planned and performed after completed 22 w.g.
The fetal anatomy scan at 28-32 weeks of gestation (optimally at 28-30 w.g.) is the third important ultrasound examination in pregnancy.
- Consequently, the fetal development and size increases in advanced gestation. Thus, the prenatal diagnosis of some rare or small structural fetal abnormalities becomes feasible;
- Furthermore, some congenital defects have late clinical onset and practically can only be diagnosed in the third trimester;
- In addition, the third trimester scan provides adequate assessment of the fetal growth and development, as well as the possibility to evaluate the blood flow in the maternal and fetal circulation by Doppler ultrasound;
- However, due to the advanced gestational age, significant bone calcification and unfavorable fetal position the scan has also some limitations - poor sonographic visualization, incomplete fetal anatomy assessment, etc.
We offer to all our patients at MC MARKOVS the three specialized ultrasound fetal anatomy scans - in the first, second and third trimester. All examinations are performed by highly qualified healthcare professionals in a comfortable environment with modern ultrasound equipment.
For more information regarding the possibilities of having a comprehensive fetal anatomy assessment at MC MARKOVS please contact your doctor or call the at the registration desk.
Specialists

Prof. Dr. Dimiter Markov, Ph.D. Obstetrician-gynecologist

Dr. Elena Pavlova, Ph.D. Obstetrician-gynecologist

Dr. Dilyana Atanasova, Ph.D. Obstetrician-gynecologist

Dr. Ivelina Dimitrova Obstetrician-gynecologist

Dr Ina Giosheva Obstetrician-gynecologist

Dr. Veneta Stoykova, Ph.D. Obstetrician-gynecologist

Dr. Diana Kostova Obstetrician-gynecologist