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At 20 weeks pregnant, you’re well into your second trimester and ready for your first big ultrasound.

What’s an ultrasound?

An ultrasound is an extremely common medical procedure used to produce images, called sonograms, at various stages of pregnancy. The most commonly known type of ultrasound is the abdominal ultrasound. During an abdominal ultrasound a technician uses a conductive gel and wand-shaped ultrasound machine to capture images of a fetus, placenta and umbilical cord.

Another way this prenatal test may be done, especially in earlier weeks, is via a vaginal ultrasound. A similar wand-shaped machine is inserted vaginally to get a better picture of your uterus and the developing baby. By 20 weeks it is not likely that you will need a vaginal ultrasound since the baby will be developed enough to view via abdominal ultrasound.

Finding out the sex of your baby

For most parents, the most exciting part about the 20 week ultrasound is that this is the stage where you are able to find out the sex of your baby. While it might not be immediately noticeable to your eye, the technician will be able to tell the sex of the baby by looking at the 20 week sonogram. If it’s a girl, her parts will look like three lines. Boy parts appear as you would expect them too, but don’t confuse the umbilical cord for a penis. It’s best not to interpret the ultrasound on your own to avoid misidentifying your new little one. You may choose to have your technician announce the sex during the appointment or put the answer in an envelope for safe keeping until a later date, such as a gender reveal party.

Sometimes it may be unclear what the sex of your baby is at the 20 week ultrasound depending on the baby’s position at the time of the scan. You may need to put on your patience a little bit longer and come back on another day to learn the sex. While waiting is difficult, it’s better to be sure than surprised.

What else can you see at the 20 week ultrasound?

Face

At 20 weeks the baby’s face will look a little like a skull mask. This is often your first chance to really see a true face and unique features forming. You may even catch a glimpse of him or her sucking on thumbs or fingers.

Spine

Many teeny tiny bones connect together to form a visible spine at 20 weeks. Some parents say they remind them of a string of pearls.

What is the doctor looking for at the 20 week ultrasound?

The 20 week ultrasound, which used to commonly be the first ultrasound, is a time when your doctor or a technician will be noting, measuring and checking off many things about the embryo, such as:

  • How many babies there are
  • Baby’s abdominal wall and spine
  • Weight and size of the embryo
  • Limbs, fingers, toes and face
  • Measurements of the baby and its various body parts to assess health and growth

Detecting abnormalities during the 20 week ultrasound

Roughly 50% of abnormalities can be detected by the 20 week ultrasound. The remainder may be detected later in gestation or at birth. About 40-70% of structural abnormalities are detectable at this time. If an abnormality is detected you will be referred to the proper doctor or specialist to discuss what that means and the options you have. Further testing may be needed to confirm the presence or severity of an abnormality before making a recommendation.

It is not uncommon for some abnormalities to be detected at 20 weeks and go away as the pregnancy progresses. Try your best to stay calm, ask questions and not jump to conclusions if things are not perfect.

How do I prepare for my 20 week ultrasound?

There are no specific instructions for preparing for your 20 week ultrasound other than booking your appointment. This is a great moment for your you and your partner to share should that be part of your plan.

A 20 week ultrasound usually takes about 45 minutes from start to finish. That being said, allow plenty of time for the appointment as a variety of things may come up that lengthen the time you need to be there and you do not want to be stressed or rushed and lose the excitement of this special day. Plan a fun outing afterward to discuss the ultrasound and assess how you’re feeling.

If you’ve experienced earlier ultrasounds, you may have learned that a full bladder helps prepare a better sonogram. At 20 weeks, this uncomfortable guideline no longer needs to be followed since the embryo is developed enough. You should avoid urinating 30 minutes before the procedure, but that’s all you need to endure. Your semi-full bladder will help push the uterus higher toward your pelvis, which makes it easier for the technician to capture images.