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The Pregnant OB Part 5: The 20-week ultrasound

Posted on Mar. 30, 2015 ( comments)
pregnant ob girl or boy

Most parents-to-be get excited about the 20-week ultrasound because they can finally discover the gender of their baby. 

But these first pictures are so much more than a gender-reveal celebration.

The true purpose of the 20-week ultrasound is to check the baby’s development. The findings, however small or large, can significantly influence the care we OBs provide throughout pregnancy and after the birth. 

You can probably imagine me at my 20-week ultrasound appointment, scrutinizing each and every detail on the screen.

Was the placenta in the right location? Where was the umbilical cord inserted into the placenta? Did the kidneys look normal? What about the heart? 

What happens at the 20-week ultrasound? 

First, the radiologist looks at what we call the surroundings. The surroundings are the placenta, cervix and amniotic fluid. 

If the placenta is in the wrong location, such as covering the cervix, the patient is at risk of significant bleeding. Strong caution is advised. 

If the cervix is too short, the mother is at risk of going into labor before the baby is full term. 

If the amniotic fluid is too low, there may be something wrong with the baby’s kidneys or the bag of water may have a leak. 

Next, we look at the details of the growing human body, from head to toe. 

Is the facial anatomy right? Is the brain correctly formed? Does the heart have all four chambers, with the correct “plumbing” to and from? Are the limbs proportional? Are the stomach and bowels healthy and free from obstruction? 

The vast majority of the time, everything looks normal. And we can also see the baby’s gender and reveal it to parents who want to know. 

When the ultrasound isn’t normal

However, when the ultrasound doesn’t appear normal, abnormalities may range from inconsequential  to life-threatening. 

This is heartbreaking, as no parent wants to hear there could be something wrong with their child.

But if there are abnormalities, detecting them in the 20-week ultrasound is helpful for making medical plans and decisions. 

No matter what the problem is, we can provide excellent obstetric care. We can also connect families with specialists, before the birth of a child with special needs, for example, so the mother and father can prepare emotionally.

So remember, all you expectant parents, that while you’re anxious to find out whether you’re having a boy or girl, your OB is actually looking for so much more. 

I’m so thankful that my 20-week ultrasound showed everything was normal. And, by the way, we’re having a boy.

Related stories
The Pregnant OB Part 1: How to find the right doctor
The Pregnant OB Part 2: First kicks
The Pregnant OB Part 3: Holding my breath
The Pregnant OB Part 4: Baby on board, will travel

More information
Find an excellent MultiCare OB/GYN to guide you through a healthy pregnancy and delivery experience.

Learn more about pregnancy and newborn care.

About The Author

Dr Sarah Chen Dr. Sarah Chen
Sarah Chen, MD, The Pregnant OB, works at our MultiCare Kent Clinic. She recently graduated from Loma Linda University and moved to the Pacific Northwest with husband Benjamin Chen, MD, an orthopedic spine surgeon at MultiCare Good Samaritan Hospital. The couple welcomed their first child into the world in July 2015.
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