A morphology scan is a detailed ultrasound performed between 20 and 22 weeks of pregnancy to assess your baby’s development. It checks major organs, the spine, limbs, and facial features, as well as the placenta, amniotic fluid,umbilical cord, and cervix. Many parents wonder what to expect during the scan, how long it takes, and how to prepare.

In this fact sheet, we’ll walk you through the entire process, including how the scan is performed, what the sonographer looks for, and what happens if your baby is in a tricky position. Understanding these details can help you feel more prepared and confident for your appointment.

Specifically, this fact sheet will cover:

1. An introduction to the morphology scan
2. What the sonographer looks for
3. Whether a full bladder is needed and how to prepare
4. How long it takes and what results you can expect
5. An interview with our Chief Sonographer, Teresa Clapham
6. Question: What does the sonographer do during a morphology scan?
7. Question: Can a morphology scan pick up all abnormalities?
8. Question: Will the scan reveal my baby’s sex?
9. Question: How is a morphology scan different from other prenatal ultrasounds?
10. Question: Am I allowed to bring a support person to the scan appointment?
11. Question: What happens if the baby isn’t in the right position to be scanned clearly?
12. Question: What structural anomalies are most commonly assessed during a morphology scan?
13. Question: How is foetal biometry used to assess gestational age and growth at the 18–22 week scan?
14. Question: What follow-up investigations are recommended if a soft marker or structural anomaly is detected?
15. How to book your morphology scan with QUFW

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An Introduction To The Morphology Scan

When you arrive for your morphology scan, you’ll check in at the clinic and may be asked to fill out some paperwork. A QUFW sonographer, who is specifically trained in pregnancy ultrasounds, will call you into the scan room and explain the procedure.

You’ll be asked to lie on an examination bed, and the sonographer will apply a warm ultrasound gel to your abdomen. This gel helps the ultrasound probe (transducer) glide smoothly over your skin and allows the ultrasound image to be created. The sonographer will then move the probe across your belly in different directions, capturing detailed images of your baby from multiple angles. They may need to apply gentle pressure to get a clearer view, particularly when examining specific organs or structures. If you have any concerns, please don’t hesitate to discuss this with your sonographer during your scan.

For more information about this process, read here.

What The Sonographer Looks For

During the morphology scan, the sonographer conducts a detailed examination of your baby’s development, carefully assessing key structures to ensure everything is forming as expected.

The scan focuses on major organs, including the brain, heart, kidneys, stomach, bladder, and liver. The sonographer checks for proper size, shape, and function, ensuring these vital organs are developing normally. The spine and limbs are also closely examined, with measurements taken to assess growth and symmetry. The face and skull are reviewed to check for any structural concerns, such as cleft lip or abnormalities in skull formation.

Beyond the baby, the scan also assesses your cervix, placenta, amniotic fluid levels, and umbilical cord. The placenta’s position is checked to rule out placenta previa, a condition where the placenta covers the cervix. Amniotic fluid levels are measured to ensure they are within a healthy range, as too much or too little fluid can indicate complications. The umbilical cord is examined for its structure and blood flow, as this is essential for delivering oxygen and nutrients to the baby.

Throughout the scan, the sonographer looks for markers of potential abnormalities. These are subtle indicators that might suggest certain conditions, such as chromosomal differences or structural concerns.

If any findings need further evaluation, your healthcare provider may recommend a follow-up scan or additional testing to gather more information. However, in most cases, the scan provides reassurance that your baby is growing and developing as expected.

Whether A Full Bladder Is Needed And How To Prepare

For most morphology scans, a moderately full bladder is required. A moderately full bladder can help lift the uterus and improve visibility, especially in earlier weeks.

To prepare, it’s best to wear loose, comfortable clothing that allows easy access to your abdomen. Some parents find that having a light meal or a cold drink before the scan may encourage the baby to move, which can help with imaging. If you’re unsure about any preparation requirements, check with us ahead of time.

How Long It Takes and What Results You Can Expect

A morphology scan typically takes 45 minutes, but this can vary depending on several factors. If the baby is in a good position, allowing the sonographer to capture all the necessary images easily, the scan may be completed more quickly. However, if the baby is facing away, curled up, or in a position that makes it difficult to assess certain structures, the scan may take longer or require a break to encourage movement.

If the baby’s position prevents a clear view of important areas, the sonographer may ask you to roll onto your side, adjust the tilt of the bed, stand up, or take a short walk to encourage movement. If the baby remains in a difficult position and the sonographer is unable to complete all necessary checks, you may need to return for a repeat scan on another day. This is common and doesn’t necessarily mean anything is wrong—it just ensures a thorough and accurate assessment.

In most cases, the sonographer will not provide detailed results immediately. Instead, they will complete the scan, document their findings, and discuss the information with a reporting QUFW doctor. If there are any concerns or unclear findings, the QUFW doctor may recommend further scans or tests for more information. If everything looks normal, no further action is needed, and the scan simply provides reassurance that your baby is developing well.

An Interview With Our Chief Sonographer, Teresa Clapham

We sat down with Teresa Clapham, Chief Sonographer at Queensland Ultrasound for Women (QUFW), to discuss the clinical importance of the morphology scan and what patients can expect from the experience.

A Comprehensive Assessment at Mid-Pregnancy

The morphology scan, also known as the 20-22 week scan, is a detailed structural assessment of the developing fetus. According to Teresa, its role extends far beyond simply checking the baby’s size or confirming gestational age.

“The morphology scan is our opportunity to assess all the baby’s major organ systems,” Teresa explains. “We look at the brain, spine, heart, kidneys, limbs, and facial structures. It’s a comprehensive screening tool designed to identify any structural anomalies that may affect pregnancy management or outcomes.”

While the scan is performed between 20 and 22 weeks, Teresa notes that the timing is carefully chosen to allow for optimal visibility of fetal anatomy while still offering time for appropriate follow-up if needed.

“By this stage, the baby is developed enough for us to visualise key structures, but we still have the option for further testing, referrals, or decisions if something unexpected is found,” she says.

More Than Just a Gender Reveal

For many parents, a common question is whether they’ll learn the baby’s sex during the scan. Many patients are already aware of the gender of their baby from their NIPT results. During the morphology examination the external genitalia is observed and correlated with the NIPT findings.

What the Scan Can, and Can’t, Detect

Despite the depth of the examination, not all conditions can be detected at the morphology scan. Teresa is clear about its limitations.

“Ultrasound has very good resolution, but there are conditions that may not be visible until later in pregnancy, or at all,” she explains. “Some anomalies are very subtle or may develop later. We always work within the boundaries of what imaging can show at a given stage.”

Patients are informed about the potential for incomplete visualisation, especially if factors such as maternal body habitus or fetal position make parts of the scan difficult.

“If we can’t see something clearly, we’ll recommend a follow-up scan. Our priority is to get accurate, complete information, even if that takes more than one appointment.”

A Shared Experience with Clinical Purpose

Many patients are surprised by how long the scan takes (often 30 to 45 minutes) and how still they’re required to remain.

“It’s a very focused process,” Teresa notes. “We capture and assess a multitudeof specific measurements and images. Some of that is diagnostic, but it’s also about record-keeping, making sure everything is documented clearly for the obstetric team.”

Support people are welcome at most morphology scans, and Teresa says it can be a powerful experience for families.

“It’s often the first time they’ve seen their baby in such detail. The heartbeat, the movement, even facial features, it’s emotional, and we don’t take that for granted.”

Still, she maintains that the role of the sonographer is firmly clinical.

“We love when parents are engaged and ask questions. Communication during the examination is integral in providing both a positive experience for the parents, but our first responsibility is also to do a thorough, systematic scan. That means there will be moments where we’re quiet and concentrating. That’s not a sign something’s wrong, it’s just how we work.”

Question: What does the sonographer do during a morphology scan?

During a morphology scan, the sonographer performs a detailed ultrasound assessment of the fetus, placenta, cervix, uterus, and amniotic fluid. The primary focus is to evaluate the baby’s anatomy and development, checking that major organs and structures are forming as expected. This includes examining the brain, face, spine, heart, lungs, stomach, kidneys, bladder, limbs, and umbilical cord. The sonographer also takes a series of biometric measurements (such as Biparietal diameter, head circumference, abdominal circumference, and femur length) to assess fetal growth and confirm gestational age.

The sonographer records a complete set of images for the obstetric team and may use colour Doppler to assess blood flow in certain areas, such as the heart or umbilical cord. If needed, they may ask you to change position or take a short break to encourage fetal movement and improve visibility.

Question: Can a morphology scan pick up all abnormalities?

No, a morphology scan cannot detect all abnormalities. While it is a highly detailed and systematic assessment, there are limitations to what can be seen on ultrasound, even when conditions are ideal. Some structural abnormalities are not visible until later in pregnancy, may develop after the scan, or may be too subtle to detect at this stage. Certain conditions, such as genetic or metabolic disorders, may not present with any visible features on ultrasound at all.

Detection also depends on factors such as fetal position, maternal body habitus, the presence of uterine fibroids or scarring, and the quality of ultrasound equipment. If an abnormality is suspected or if visibility is limited, the sonographer may recommend a follow-up scan, referral to a maternal–fetal medicine specialist, or further testing such as non-invasive prenatal testing (NIPT), amniocentesis, or MRI.

Question: Will the scan reveal my baby’s sex?

In most cases, yes. The morphology scan can reveal the baby’s sex if the baby is in a favourable position and visibility is clear. The sonographer will examine the external genitalia as part of the scan and can usually determine the sex with reasonable accuracy from around 16 weeks onward.

The sonographer’s main focus is on assessing fetal anatomy and development. If determining the sex is important to you, it’s best to let the sonographer know at the beginning of the appointment. In some cases, the baby’s position or movement may make it difficult to confirm with confidence. This is often correlated with prior NIPT results.

Question: How is a morphology scan different from other prenatal ultrasounds?

The morphology scan differs from other prenatal ultrasounds in its level of detail and its clinical purpose. While earlier scans (such as the dating scan or early anatomy/first trimester screening) focus on confirming pregnancy viability, estimating due date, and assessing early risk factors, the morphology scan provides a full structural review of the fetus at the mid-point of pregnancy (usually between 20 and 22 weeks).

Key differences include:

• Scope of assessment: The morphology scan systematically examines each major organ system, measures fetal growth parameters, and evaluates the placenta, cord, uterus, and amniotic fluid. Earlier scans are more limited in what can be visualised due to the fetus’s smaller size.
• Timing: Most general ultrasounds occur earlier (around 6–13 weeks) or later (after 28 weeks) and have different goals, such as confirming location, detecting multiple pregnancies, or monitoring growth and wellbeing. The morphology scan is timed specifically for optimal anatomical assessment.
• Duration and complexity: The morphology scan usually takes longer and requires more precision. It may involve colour Doppler or additional imaging techniques to assess cardiac and vascular structures. The findings are used to inform pregnancy care and, if necessary, plan for further investigations or specialist referral.

Question: Am I allowed to bring a support person to the scan appointment?

You’re welcome to bring up to two support people to your morphology scan at QUFW. One of these may be a child, provided they are accompanied by an adult who can supervise them during the appointment. Ultrasound scans can take time and involve extended periods of stillness, so it’s important that children are occupied and cared for throughout.
Having a partner, relative, or close friend with you can offer reassurance and make the experience more meaningful. However, as this is a clinical assessment, your sonographer will need to remain focused to ensure precise imaging and measurements.

If your support person can’t be present, you’re welcome to briefly video call them during the scan, where appropriate. Please speak with our staff beforehand to check suitability. For patients attending as surrogates, our team can accommodate specific arrangements and will be happy to discuss this when you book.

Question: What happens if the baby isn’t in the right position to be scanned clearly?

If the baby is not in an ideal position during the scan, the sonographer may ask you to change positions, go for a short walk, or return later in the day. These strategies can encourage the baby to move into a better position, making it easier to obtain clear views of the necessary structures.

In some cases, not all areas can be adequately assessed during the appointment. If this occurs, you may be asked to return for a follow-up scan to complete the assessment. This is relatively common and does not necessarily mean there is a problem, it simply ensures the sonographer can obtain the full set of diagnostic images required for accurate reporting.

Question: What structural anomalies are most commonly assessed during a morphology scan?

During a morphology scan, the sonographer systematically examines the fetus for a range of structural anomalies. These assessments focus on identifying abnormalities that could affect health, development, or require further investigation during pregnancy or after birth.

Commonly assessed areas include:

• Central nervous system: Assessment of the brain structures (ventricles, cerebellum, midline) and spine to check for neural tube defects such as spina bifida.
• Cardiac structures: Visualisation of the four chambers of the heart, outflow tracts, and great vessels to detect congenital heart defects such as ventricular septal defects or transposition of the great arteries.
• Face and neck: Checking for cleft lip or palate, abnormal facial profile, or neck masses.
• Abdominal wall and organs: Evaluation of the abdominal wall (for defects such as gastroschisis or omphalocele), stomach, kidneys, bladder, and bowel.
• Skeletal system: Assessing limb presence, length, and symmetry to identify limb reduction defects or skeletal dysplasias.
• Thorax and lungs: Ensuring normal chest shape and size and identifying masses or signs of diaphragmatic hernia.

Each area is reviewed with multiple cross-sectional images to look for structural deviations. If an abnormality is detected, the patient may be referred for further follow up ultrasound scans (such as a fetal echocardiogram), a fetal MRI depending on the abnormality or further genetic counselling, depending on the findings.

Question: How is foetal biometry used to assess gestational age and growth at the 20–22 week scan?

Fetal biometry involves taking standardised measurements of the fetus to assess both gestational age and growth patterns. At the 20–22 week morphology scan, these measurements help confirm whether the baby is growing in line with expected milestones for the given stage of pregnancy.

Key biometric parameters include:

• Biparietal diameter (BPD) – measures the width of the skull at the level of the thalami.
• Head circumference (HC) – provides a more comprehensive assessment of head size and development.
• Abdominal circumference (AC) – reflects fetal growth and is sensitive to growth restriction or macrosomia.
• Femur length (FL) – measures the length of the thigh bone, contributing to overall growth assessment.

These values are compared against gestational age norms to evaluate whether growth is within expected ranges. If measurements fall significantly outside normal parameters, it may prompt further monitoring or investigation to rule out conditions such as intrauterine growth restriction (IUGR), macrosomia, or skeletal dysplasia. Biometry also supports the confirmation of due dates established earlier in pregnancy, though dating is most accurate in the first trimester.

Question: What follow-up investigations are recommended if a soft marker or structural anomaly is detected?

If a structural anomaly is detected during the morphology scan, the next steps depend on the nature, number, and severity of the findings, as well as the patient’s risk factors and preferences. Our QUFW maternal fetal medicine (MFM) and COGU Sonologists will discuss the findings and provide you and your doctor with any further follow up recommendations. Common follow-up investigations include:

• Referral for further imaging: Further follow up ultrasounds within QUFW, fetal echocardiography at a Tertiary clinic may be organised to provide further clarity or information.
• Non-invasive prenatal testing (NIPT): A blood test that analyses fetal DNA circulating in maternal blood to screen for common chromosomal abnormalities such as trisomy 21, 18, and 13.
• Amniocentesis: A diagnostic test that samples amniotic fluid to directly analyse the fetal chromosomes or genetic material. This is usually offered when there is a significant concern about a genetic condition.
• Fetal MRI: Occasionally used if a central nervous system abnormality is suspected and further anatomical detail is needed beyond what ultrasound can provide.
• Serial growth scans: If the anomaly relates to growth parameters or placental function, repeat ultrasounds may be scheduled to monitor fetal growth and wellbeing over time.
• Genetic counselling: Offered to help parents understand the potential implications of findings, the likelihood of recurrence, and available testing or support options.

Each case is reviewed individually, and the care team works with the patient to determine the most appropriate pathway based on clinical evidence and personal values.

Book Your Morphology Scan With QUFW

Queensland Ultrasound for Women (QUFW) offers comprehensive morphology scans at four convenient locations across South East Queensland. Our sonographers use advanced imaging technology to provide detailed assessments in a professional, supportive environment.

To schedule your morphology scan, contact your nearest QUFW practice today. Early booking is recommended to secure an appointment within the ideal scan window.