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Single Best Answer (SBA) · Obstetric Ultrasound

A clinician schedules the anomaly scan. Which single timing and purpose is correct?

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Answer: A. At 18-22 weeks, to survey fetal structure and localise the placenta

The anomaly scan (USS2)

Routine ultrasoundTiming and purpose
Dating scan (USS1)10-13+6 weeks; crown-rump length (CRL) for dating; viability, number/chorionicity; nuchal translucency
Anomaly scan (USS2)18-22 weeks; structural survey; placental localisation
Growth scans (USS3)Serial (e.g. 28, 32, 36 weeks); AC, HC, BPD, FL -> estimated fetal weight
Delivery planning (USS4)Presentation, placenta, liquor near term
Timing and purpose
  • Performed at 18-22 weeks.
  • It surveys the structure of major organs (including the heart) and localises the placenta.
Placental localisation
  • About 15-20% of women have a low-lying placenta at 20 weeks, but most 'migrate' upward as the lower segment forms; only about 10% of these turn out to have placenta praevia.
Cardiac detection
  • The routine scan has limited sensitivity for major cardiac defects; specialist echocardiography detects more in high-risk pregnancies.

So the anomaly scan is at 18-22 weeks for the structural survey and placental localisation.

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