What to Expect During Pregnancy Ultrasounds

pregnancy ultrasound
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If you recently found out you're pregnant, the date of that first pregnancy ultrasound is something you are likely eagerly looking forward to. Finally a chance to catch a glimpse of your little one! Will you be able to see a family resemblance in that grainy black and white image? Are you having a boy or a girl? Many people even share ultrasound images on social media for all the world to see.

As exciting as ultrasounds can be, they are also an important diagnostic medical procedure that helps keep you and your baby safe and healthy during pregnancy. At times, ultrasounds can be stressful for parents, especially if they are being used to diagnose an issue in your pregnancy or your baby.


Stay Calm Mom: Everything to Know About Ultrasounds

The Purpose of Ultrasounds in Pregnancy

Obstetricians and other healthcare professionals use ultrasounds to view babies, and all their precious parts, in utero.

Ultrasounds use sound waves to create images of your baby as well as your uterus, placenta, and surrounding blood vessels and organs. During the ultrasound exam, an instrument called a transducer sends sound waves through your body. The waves are then echoed back to the transducer, which transforms them into images that are viewed on a video screen.

Ultrasound technology images your baby’s body and organs, thereby checking their health and development. In addition, ultrasound technology may be used for:

  • Verifying your pregnancy
  • Ascertaining how many weeks pregnant you are
  • Learning how many fetuses you are carrying
  • Checking for abnormalities in your cervix and uterus
  • Monitoring your pregnancy
  • Checking for any fetal abnormalities
  • Helping guide diagnostic procedures such as chorionic villus sampling and amniocentesis
  • Noting your amniotic volume
  • Looking at the health of your placenta
  • Investigating any pregnancy complications you may be experiencing, such as abnormal bleeding
  • Determining your baby’s position as birth draws closer

Are There Risks to Ultrasounds?

Ultrasound technology has been used for years in pregnancy and there is no known risk, especially when used appropriately and for medical reasons only. The lowest, most effective amount of ultrasound energy should be used.

The main concern with ultrasounds is that while they are helpful, they can’t detect all fetal abnormalities, and that sometimes they produce false positive results.

Types of Ultrasounds Used in Pregnancy

When you picture your big pregnancy ultrasound, you are likely thinking of the one that occurs mid-way through your pregnancy (18 to 22 weeks), where you find out things such as the sex of your baby. That’s because that mid-pregnancy ultrasound is something almost all pregnant women have, and it involves a detailed (and very exciting) examination and view of your little one.

Yet that isn’t the only ultrasound pregnant people experience. There are actually several different types of ultrasounds that you may have during pregnancy, all of which have slightly different purposes.

There are two main kinds of ultrasound used during pregnancy—transvaginal and transabdominal.

Transvaginal Ultrasound

During this type of ultrasound, a wand-shaped transducer is placed inside your vagina. Transvaginal ultrasounds are usually used in early pregnancy to verify your pregnancy, check your baby’s heart rate and position, look for signs of ectopic pregnancy, and detect how many fetuses are present. But they may also be used later on in your pregnancy if abdominal ultrasounds aren’t providing enough information.

Transabdominal Ultrasound

Transabdominal ultrasounds use a transducer that is placed on your abdomen to view your baby and check on your pregnancy.

It is routine to receive a thorough transabdominal ultrasound about 18 to 22 weeks into your pregnancy, but they can be used later on in your pregnancy if anything of concern comes up that needs to be investigated or monitored.

3D Ultrasound

This type of ultrasound can be done transvaginally or transabdominally. 3D ultrasound is used when more detailed images of your baby are needed. It can help detect conditions such as neural tube defects and facial abnormalities. 

Doppler Ultrasound

Doppler ultrasounds are used to observe movement within blood vessels and can provide information about your baby’s blood flow, as well as the blood flow in your uterus and placenta.

Fetal Echocardiography

Fetal Echocardiography allows doctors to see a detailed image of your baby’s heart and heart structures. It may be used if a congenital heart defect is suspected.

How to Prepare for Your Ultrasound

In some cases, you will be asked to come to your ultrasound with a full bladder, as a full bladder helps give the ultrasound technician a clearer view of the structures they are looking to image.

If you are going to be getting a transabdominal ultrasound, you may want to wear loose fitting clothing, so the technician will have easy access to your belly. Your doctor or ultrasound center may give you more detailed instruction for how to prepare for the exam.

You might feel nervous or on edge when you go to get an ultrasound during pregnancy. That’s normal and understandable, but you should know that although the results of the ultrasound can be stressful at times, the procedure itself is rarely uncomfortable. And in most cases, there is nothing to worry about in terms of what your doctor will find on the exam.

What to Expect During an Ultrasound

A transvaginal exam will be similar to any pelvic exam you have had at your gynecologist. For this exam, you will usually be asked to empty your bladder beforehand. You will lie on your back on the exam table, usually in a hospital gown. You may be asked to put your feet in stirrups.

The transducer wand will have a sterile protective sheath (like a condom) and will be lubricated for easy insertion and comfort. The wand will be inserted into your vagina and gently moved around so your doctor can find all the important structures that need to be viewed. You will be able to see images of your uterus and fetus on a video screen.

During a Transabdominal Exam

You will lie on an exam table for your transabdominal ultrasound. Your belly—from your ribs to hips—will need to be exposed. The sonographer will use a special gel, which will be smeared across your belly. Then they will run the transducer across your belly, pausing at various points as images are generated.

Depending on what the purpose of the exam is, the sonographer may need to spend time searching for the structures they are looking for. During the standard 18- to 22-week exam, there is a long list of items the sonographer is supposed to view, so this exam can take some time.

Questions to Ask During or After Your Ultrasound

If your ultrasound is performed by your doctor, you may be able to get immediate results. Usually transvaginal ultrasounds are performed by OB/GYNs and they will be able to narrate what they see.

The standard 18- to 22-week transabdominal exam is often performed by an ultrasound technician, who usually cannot divulge what information they are seeing, and will need to send a report back to your healthcare provider, who can then review it and give you the information. However, most ultrasound technicians will be able to tell you the sex of your baby—if that’s something you want to know!

Waiting for exam results can be challenging and worrisome, especially if the ultrasound was used to diagnose or investigate a problem with your pregnancy or your baby. Make sure that you receive the emotional support you need to get through these days of uncertainty. Connecting to other parents who have experienced similar issues can be extremely helpful.

Once your ultrasound results are in hand, the questions you want to ask your doctor will vary depending on the reason why the ultrasound was performed.

If there are any abnormalities detected in the ultrasound, you shouldn’t be afraid to ask your doctor as many questions about these as needed. Ask what these findings mean for your baby’s future, how certain and verifiable the findings are, and what comes next in terms of testing and preparation.

If your doctor’s explanations lack clarity or if you suspect something is missing or may be awry, consider getting a second opinion.

If you are told you will need a series of ultrasounds going forward, make sure to ask what the schedule for these ultrasounds will look like, when determinations of your and your baby’s health will be made, and what your doctor expects to learn from the exams.

If ultrasounds end up feeling stressful to you, it can be very helpful to go in with a written list of questions, and to have a trusted loved one with you during the exam, such a partner, friend, or family member.

A Word from Verywell

Your ultrasound exam may be something you consider to be a highlight of your pregnancy—and most of the time, ultrasounds truly are exciting! But it’s important to understand that they are also medical procedures used to ensure a healthy pregnancy and safe delivery. As such, ultrasounds should be used for medical purposes only, and only when prescribed by a doctor.

In some cases, the results—or impending result—of a pregnancy ultrasound can be concerning for expectant parents. You should know that your medical team will do its very best to keep you safe, informed, and use the data gathered to ensure the best outcome for your pregnancy. You should always feel empowered to ask your doctor any pertinent questions—that’s what they are there for.

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  • American College of Obstetricians and Gynecologists. Ultrasound exams. Updated June 2020.

By Wendy Wisner
Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.