My Health Record

QUFW is currently unable to upload ultrasound reports to My Health Record due to a temporary system limitation. In the meantime, all patients will continue to receive a copy of their ultrasound report following their examination, and a copy will also be provided to their referring practitioner. If you would like your ultrasound report to be uploaded to My Health Record once this functionality becomes available, please email [email protected] with your request. We appreciate your patience and understanding and apologise for any inconvenience. — QUFW Management

Saline infusion sonography (SIS) fact sheet: what to expect from your uterine cavity assessment

Saline infusion sonography (SIS) fact sheet: what to expect from your uterine cavity assessment

Investigations involving the uterus can feel daunting, especially when they follow symptoms such as abnormal bleeding, fertility challenges, or pregnancy loss. Many patients arrive unsure about what the test involves, how uncomfortable it might be, or what information it will provide.

This fact sheet explains what a Saline Infusion Sonography (SIS) examination is, why it is performed, and what you can expect before, during, and after the procedure. In this article, Jacqui, Lead Gynaecological Sonographer at QUFW, talks you through the SIS examination and how it helps assess the lining and shape of the uterus.

Medical disclaimer: The information in this article is general in nature and provided for educational purposes only. It does not replace medical advice, diagnosis, or treatment. Please consult your GP or specialist for personalised care.

Table of contents

  1. What is a saline infusion sonography (SIS)?
  2. Why would a SIS be recommended?
  3. When is a SIS performed?
  4. How do I prepare for my SIS appointment?
  5. How is the SIS procedure performed?
  6. What will I feel during the SIS procedure?
  7. How long does a SIS appointment take?
  8. When and how do I receive my SIS results?
  9. Is SIS safe?
  10. After the procedure: recovery and care
  11. Book your gynaecology scan at QUFW
  12. References
  13. Video transcript

What is a saline infusion sonography (SIS)?

A Saline Infusion Sonography (SIS) is a specialised ultrasound procedure used to assess the internal cavity of the uterus.

“An SIS is an ultrasound procedure that provides information relating to the internal cavity of the uterus,” Jacqui explains.

During the procedure, a sterile saline (salt-water) solution is gently introduced into the uterus. This fluid separates the walls of the uterine cavity, allowing the endometrial lining to be seen more clearly on ultrasound.

“An SIS uses a salty water solution inserted into the uterus, which allows visualisation of the lining of the uterus, the endometrium.”

This enhanced view helps identify abnormalities that may not be visible on a standard transvaginal ultrasound.

Why would a SIS be recommended?

You may be referred for an SIS for several reasons.

“An SIS is used to detect abnormalities of the lining of the uterus,” says Jacqui.

Common indications include:

  • Abnormal uterine bleeding
  • Infertility investigations
  • Recurrent miscarriages
  • Suspected uterine polyps or fibroids
  • Congenital uterine anomalies
  • Assessment of uterine shape
  • Adhesions or scar tissue

SIS is particularly useful when symptoms persist but routine ultrasound findings are inconclusive.

When is a SIS performed?

Timing is important for both safety and diagnostic accuracy.

“The procedure needs to be performed between four to ten days after the first day of your last menstrual period,” Jacqui explains.

Our doctors perform the procedure after a thorough transvaginal assessment of the pelvic organs has been performed by our sonographers.

Patients are advised to contact QUFW on day one of their period to schedule the examination. If cycles are irregular or infrequent, individual advice is provided.

This timing reduces the chance of early pregnancy and allows optimal assessment of the endometrium.

Saline Infusion Sonography (SIS) showing the endometrial cavity in the coronal plane

How do I prepare for my SIS appointment?

Preparation is simple and focused on comfort.

“You do not require a full bladder for the procedure,” Jacqui notes.

You may be asked to:

  • Refrain from sexual intercourse before the procedure
  • Have a pregnancy blood test if required
  • Take your preferred pain medication one hour beforehand

You are welcome to bring a support person, although this is optional.

How the SIS procedure is performed

On arrival, you will complete a urine pregnancy test to confirm you are not pregnant.

A transvaginal ultrasound is performed first to assess the pelvis. Once complete, the doctor will:

  • Insert a speculum
  • Gently pass a thin, flexible catheter through the cervix into the uterus

“As the catheter passes through the cervix, you may feel pain,” Jacqui explains.

Once positioned, a small balloon at the end of the catheter is inflated to hold it in place. The speculum is then removed, and the transvaginal probe is reinserted.

Saline is passed through the catheter into the uterine cavity.

“This is assessed for any scarring, polyps, or fibroids that are difficult to assess on transvaginal ultrasound.”

The ultrasound captures real-time images as the cavity is distended.

What will I feel during the SIS procedure?

Sensations vary between patients.

Some may feel:

  • Period-like cramping
  • Pelvic pressure
  • Light-headedness, warmth, or dizziness

“This should settle with time,” Jacqui reassures.

Pain relief can be used if needed, and patients are encouraged to communicate any discomfort during the procedure.

Saline Infusion Sonography (SIS) showing a 3D coronal reconstructed image of a submucosal fibroid

How long does a SIS appointment take?

“We allow 45 minutes for the procedure,” Jacqui explains.

This includes:

  • The initial transvaginal ultrasound
  • Preparation and setup
  • The SIS itself

“The procedure itself does not take long and should be completed in about 10 minutes.”

When and how do I receive my SIS results?

Results are often discussed as the procedure is performed.

“The doctor will explain any results and any additional pathology that may be discovered.”

Your results are:

  • Sent directly to your referring doctor
  • Shared with you via a secure Tricefy link on your mobile

Report timing depends on the complexity of the findings and whether additional pathology is identified.

Is SIS safe?

“The SIS procedure is very safe,” says Jacqui.

SIS:

  • Does not involve ionising radiation
  • Does not require general anaesthetic

Pelvic infection is uncommon. You should seek medical advice if you experience:

  • Severe pelvic pain
  • Fever
  • Green or yellow vaginal discharge

“It is also okay to have intercourse after the procedure.”

After the procedure: recovery and care

After an SIS, it is normal to experience:

  • Watery or bloody discharge
  • Mild bloating
  • Lower abdominal discomfort or cramping

A sanitary pad is provided. Spotting or light bleeding may continue for a day or two and usually settles without treatment.

Pain relief may be used if required.

Book your gynaecology scan at QUFW

Investigations involving bleeding, fertility concerns, or pregnancy loss can feel emotionally and physically draining. Having a clear explanation of what is happening inside the uterus can provide reassurance and direction.

At QUFW, gynaecology scans are performed using evidence-based protocols in a supportive, respectful environment. Your SIS examination is designed to provide accurate information to guide diagnosis and next steps in your care.

Learn more here or contact us here.


References

  • de Kroon, C. D., de Bock, G. H., Dieben, S. W., & Jansen, F. W. (2003). Saline contrast hysterosonography in abnormal uterine bleeding: a systematic review. BJOG, 110(10), 938–947. https://pubmed.ncbi.nlm.nih.gov/14550365/

Video transcript

Hi, my name’s Jacqui. I’m the lead gynaecological sonographer for QUFW and I’m going to talk you through your Saline Infusion Sonography (SIS) at QUFW. An SIS is an ultrasound procedure that provides information relating to the internal cavity of the uterus. An SIS uses a salty water solution inserted into the uterus, which allows visualisation of the lining of the uterus, the endometrium. An SIS is used to detect abnormalities of the lining of the uterus.

You may have been sent for an SIS to investigate abnormal uterine bleeding, infertility, recurrent miscarriages, or to detect uterine abnormalities such as fibroids or polyps, congenital defects, assessing the shape of your uterus, or adhesions or scar tissue. The procedure needs to be performed between four to ten days after the first day of your last menstrual period. We advise you to call the office on day one of your period to make a booking.

If you have irregular cycles or infrequent periods, please call to be advised appropriately. Some patients may be asked to refrain from sexual intercourse prior to the procedure and/or have a pregnancy blood test. You do not require a full bladder for the procedure. It is recommended to take your choice of pain medication an hour before the procedure. You may bring a support person to your appointment, but it is not a requirement.

What to expect — how is it performed?

Upon arrival at our clinic, you’ll be asked to perform a urine pregnancy test to ensure you are not pregnant. A transvaginal ultrasound is required prior to the procedure. Once the pelvic ultrasound is complete, the doctor will use a speculum and insert a thin, flexible catheter through your cervix that will go into the uterus. As the catheter passes through the cervix, you may feel pain, and once it’s in position, a small balloon on the end of the catheter will be inflated.

You may experience some additional pressure or period-like pain. This should settle with time. The speculum will then be removed and the transvaginal probe will be inserted again so we can visualise the procedure. Saline, a salt-water solution, is passed through the catheter to check the cavity of the uterus. This is assessed for any scarring, polyps, or fibroids that are difficult to assess on transvaginal ultrasound. The transvaginal probe captures real-time images of the cavity.

When the procedure is finished, the catheter and probe will be removed. Some patients may feel lightheaded, hot, or dizzy during the procedure. Some women may experience mild cramping that is similar to period pain. This will resolve shortly after the procedure, and pain relief can be used to alleviate these symptoms. If this occurs, please let either the doctor or sonographer know, and they will try to make you feel more comfortable.

We allow 45 minutes for the procedure. This includes the transvaginal ultrasound and setup. The procedure itself does not take long and should be completed in about 10 minutes.

When will I get the results of the procedure?

As the procedure is performed, the doctor will explain any results and any additional pathology that may be discovered. Your results will also be sent directly to your referring doctor. You’ll also receive a copy of the report sent to you via a link called Trisify to your mobile. The time taken for your doctor to receive the written report will depend on the complexity of the examination and whether there is any additional pathology that has been seen.

Immediately after the procedure, you may notice a watery or bloody discharge. This is the saline that was inserted through the catheter. You’ll be provided with a sanitary pad for this reason. It is normal after an SIS to experience some bloating, mild lower abdominal pain, or cramping. This may be treated with any pain medication suitable for you. Bleeding and spotting are common side effects and should settle over the next couple of days.

The SIS procedure is very safe. An SIS does not require ionising radiation or a general anaesthetic. It is not normal to experience bad pelvic pain, fever, or smelly vaginal discharge that is green or yellowish in colour. Pelvic infection is uncommon following the procedure, but if these symptoms arise, contact your GP or referring doctor as soon as possible. It is also okay to have intercourse after the procedure. If you have any concerns, please contact the referring doctor.

====================

Content Disclaimer

The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your obstetric doctor or other qualified provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.

The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.

QUFW expands to Toowoomba with new ultrasound clinic

QUFW expands to Toowoomba with new ultrasound clinic

An exciting announcement from QUFW’s founders, Assoc. Prof. Robert Cincotta and Dr. Jackie Chua

“We are delighted to announce the opening of QUFW Toowoomba, our newest obstetrics and gynaecological ultrasound practice, located at the 201a, Level 2, Medici Medical Centre, 15 Scott St, East Toowoomba.

This new location represents another significant step in QUFW’s ongoing commitment to making high-quality ultrasound care more accessible to women and families across southern Queensland.

As part of this exciting development, QUFW has acquired the sonography practice Women’s Health Only Ultrasound, strengthening our local presence and ensuring continuity of care for patients in the region. QUFW remains independently owned and operated.

We are also thrilled to welcome Mary-Louise Barnes, formerly of Women’s Health Only Ultrasound, to the QUFW family. Mary-Louise brings extensive experience and a special interest in obstetrics ultrasound, in particular tertiary imaging.. She will be joined by Allison Mander, an accomplished sonographer with a special interest in gynaecological ultrasound, in particular endometriosis assessment. Together, they form a skilled and compassionate team dedicated to delivering the standard of care that QUFW is known for.

All scans performed at QUFW Toowoomba will be reported by QUFW’s existing team of doctors, maintaining the same high level of diagnostic quality, accuracy, and care that our patients and referring clinicians have come to expect.

The addition of QUFW Toowoomba strengthens our ability to support both patients and referring clinicians throughout the Darling Downs. This expansion marks an important milestone in our mission to provide expert, patient-centred ultrasound services across Queensland.

We look forward to welcoming patients from 24 November 2025 and invite our community to follow our growth as we continue to expand women’s imaging services in regional centres.”

Rob and Jackie

QUFW Toowoomba
201a/ Level 2
Medici Medical Centre
15 Scott St, East Toowoomba, QLD 4350

For more information or to book an appointment, please call 07 4542 7855

The 13 Week Ultrasound in Context: How It Complements NIPT and Guides Pregnancy Care

The 13 Week Ultrasound in Context: How It Complements NIPT and Guides Pregnancy Care

Non-invasive prenatal testing (NIPT) has become an important part of early pregnancy care, giving parents insight into their baby’s chromosomes through a simple blood test. But even if NIPT has been done, the 13 week ultrasound is still essential. For parents, it offers a first real look at how the baby is physically developing: seeing the heartbeat, movements, and early features that blood tests alone can’t show. For clinicians, this scan provides anatomical and placental information that NIPT cannot detect, such as structural abnormalities, growth patterns, and chorionicity in multiple pregnancies. Together, NIPT and ultrasound form a more complete picture, combining genetic information with visible evidence of development and maternal health.

In this fact sheet, we will explore:

  1. What NIPT Does and Doesn’t Do
  2. Key Assessments at 13 Weeks
  3. Detecting Early Concerns
  4. Screening for Maternal Health
  5. How Results Shape Care

—————

1. What NIPT Does and Doesn’t Do

NIPT is a powerful tool, but it has limits. For parents, it’s helpful to know what questions a blood test can answer — and what still requires an ultrasound. For clinicians, understanding the complementary role of each test ensures a balanced approach to screening.

What NIPT does well:

  • Detects common chromosomal conditions such as Trisomy 21 (Down syndrome), Trisomy 18, and Trisomy 13
  • Can also check for sex chromosome conditions (depending on the test type)
  • Provides a high degree of accuracy, reducing the need for some invasive tests
  • Uses a simple blood sample, posing no risk to the pregnancy

What NIPT doesn’t do:

  • Does not check the baby’s anatomy or detect structural abnormalities
  • Cannot show how the placenta is forming or functioning
  • Cannot confirm growth, heartbeat, or the number of babies
  • May still require follow-up ultrasound or diagnostic testing if results are high risk
NIPT 13 Week Ultrasound
Analyses cell-free placental DNA in maternal blood Provides a real-time view of the baby and placenta
Detects chromosomal abnormalities with high sensitivity and specificity Detects structural abnormalities (brain, face, spine, heart, limbs, abdomen and abdominal wall)
Non-invasive to the pregnancy, no physical risk to the developing fetus Non-invasive, visual reassurance for parents
Cannot assess physical growth or maternal health risks Screens for preeclampsia risk and placental development
Often done from 10 weeks onwards Performed between 13 weeks and 13 weeks 6 days

 

In practice, NIPT answers questions about chromosomes, while the 13 week ultrasound answers questions about development and health.

2. Key Assessments at 13 Weeks

During the 13 week ultrasound, several important checks are carried out to build a clear picture of how the pregnancy is progressing. The scan confirms the baby’s heartbeat and viability, providing reassurance while also establishing cardiac activity, rhythm, and rate. Growth is measured through the crown–rump length, which is the most accurate way to confirm gestational age and due date between 11 and 14 weeks.

The scan may also determine the number of babies, if not confirmed during an early dating/viability scan, confirming whether it is a single or multiple pregnancy. In multiple pregnancies, chorionicity and amnionicity are identified, which are essential for planning care. Placental development is reviewed, with the location and attachment site documented so any early concerns can be monitored.

Finally, an early anatomy review is performed, allowing a first assessment of the brain, face, heart, spine, abdomen, abdominal wall, limbs, and other structures. While detailed anatomy scans follow later in pregnancy, this early survey can sometimes detect major abnormalities, giving families and clinicians valuable information sooner.

Early structural assessment of the upper limbs

3. Detecting Early Concerns

One of the main strengths of the 13 week ultrasound is its ability to highlight potential issues earlier in pregnancy, giving families more time to understand their options and clinicians more time to plan care.

Areas where concerns may be detected include:

  • Structural abnormalities such as issues with the brain, face, spine, abdomen, abdominal wall, or limbs
  • Chromosomal indicators like increased nuchal translucency or absent nasal bone
  • Placental concerns that could affect growth and development later in pregnancy
  • Signs of complications in multiple pregnancies, such as unequal sharing of the placenta
Possible Concern What the Scan May Show Next Steps
Brain or skull abnormality Absence of skull bones (acrania), irregular brain structure Referral for detailed scan, genetic counselling
Facial structures Absence of the Nasal bone, suggestion of early features of cleft lip/palate, facial development of the orbits Referral for detailed scan, genetic counselling
Spinal abnormality Abnormal curvature, incomplete closure of spine Specialist ultrasound, ongoing monitoring
Abdominal structures Presence of stomach, diaphragm, bladder, kidneys, 3 vessel cord
Abdominal wall defect Organs seen outside abdominal cavity as in exomphalos, gastroschisis Referral to tertiary care, surgical planning
Increased NT or absent nasal bone Higher chance of chromosomal condition

Further assessment of fetal cardiac structures

Follow-up with NIPT, CVS, or amniocentesis

Further cardiac evaluation in the event that the NT measures >3.5mm and low risk NIPT or normal karyotype has been performed.

Placental issues Abnormal attachment such as early detection of Placenta Accreta Spectrum. Monitoring, follow-up scans later in pregnancy
Twin complications Discordant growth, shared placenta risks Closer surveillance, specialist input

 

By identifying these concerns early, the 13 week scan helps guide whether further investigations or specialist referrals are needed. It is not a diagnosis on its own but an important first step in recognising when closer attention may be required.

Early structural assessment of the spine

4. Screening for Maternal Health

The 13 week ultrasound also provides information about the mother’s health and how the pregnancy may progress. A key focus at this stage is the risk of preeclampsia, a condition that can cause high blood pressure and complications later in pregnancy. The scan can be combined with maternal blood pressure readings, blood test results, and medical history to estimate the likelihood of developing preeclampsia. If a higher risk is identified, early interventions such as low-dose aspirin and closer monitoring can be recommended, improving outcomes for both mother and baby.

Placental development is another area of assessment. The position and quality of the placenta are reviewed to ensure it is developing normally and providing adequate support for the pregnancy. Identifying placental issues early helps clinicians plan follow-up care and keep a close watch on the baby’s growth throughout the second and third trimesters.

5. How Results Shape Care

The results of the 13 week ultrasound, especially when considered alongside NIPT, shape how care is managed for the rest of the pregnancy. Together, the two tests provide a comprehensive view: NIPT offers insight into the baby’s chromosomes, while ultrasound shows physical development, placental function, and maternal health factors. This combined approach helps guide decisions about further testing, the need for specialist referrals, and the level of monitoring required.

For parents, this means reassurance that the pregnancy is being tracked with the best tools available, and that potential issues can be identified earlier rather than later. For clinicians, it provides a structured baseline that supports personalised care throughout the pregnancy.

The 13 week ultrasound is therefore much more than a milestone moment to see the baby on screen. It is a pivotal point in early pregnancy care, one that combines emotional connection with medical precision. Used together with NIPT, it ensures families and healthcare providers have the clearest possible picture to support a safe and healthy journey ahead.

====================

Content Disclaimer

The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your obstetric doctor or other qualified provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.

The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.

Understanding the 13 Week Ultrasound: Early Anatomy and Screening Insights

Understanding the 13 Week Ultrasound: Early Anatomy and Screening Insights

The 13 week ultrasound is one of the most important early scans in pregnancy. Usually performed between 13 weeks and 13 weeks 6 days, it gives parents a first detailed look at their baby’s growth and development, often providing reassurance as they see the heartbeat, movements, and forming features. At the same time, this scan holds significant clinical value. It marks the end of the first trimester, when crown–rump length measurement is most accurate for dating the pregnancy, nuchal translucency assessment is most reliable, and an early structural survey can detect major anomalies. These combined insights make the 13 week ultrasound both a meaningful milestone for parents and a cornerstone of first trimester screening and early pregnancy care.

This fact sheet covers these topics:

  1. Why the 13 Week Scan Matters
  2. Early Anatomy Check
  3. Chromosomal Abnormality Screening
  4. Maternal Health Screening

—————

1. Why the 13 Week Ultrasound Matters

The 13 week ultrasound plays a key role in checking that your pregnancy is progressing as expected. It confirms your baby’s heartbeat, measures growth, and if not confirmed in an earlier viability ultrasound can identify whether you are carrying one baby or multiples. Its major purpose is to assess the early anatomical structures that have developed by 13 weeks. The scan can also assess the placenta to check its position is appropriate at this early gestation, however it is important to note that placental position is largely checked at the 20 week morphology assessment. For parents, these checks bring reassurance that things are on track, while for clinicians, they provide vital data for guiding care for the ongoing pregnancy.

At this stage, crown–rump length measurement helps establish accurate gestational age, chorionicity can be determined in multiple pregnancies, and the position of the placenta is documented. Together, these findings set the foundation for monitoring both maternal and fetal health as the pregnancy continues.

2. Early Anatomy Check

At around 13 weeks, ultrasound technology allows a first look at your baby’s developing anatomy. For parents, this is often the first time you see just how much detail has already formed, including tiny hands and feet, the curve of the spine, and the outline of the brain. For clinicians, this scan provides a systematic review of early structures that can reveal major anomalies at an earlier stage than later pregnancy scans.

Key areas assessed include:

  • Brain, skull and face – ensuring the skull is formed, the brain appears normal for this gestational age and the early facial structures are developed
  • Spine – checking alignment and early closure of the neural tube
  • Heart – confirming rhythm and looking at the early chambers
  • Abdomen and abdominal wall – ruling out major structures such as diaphragm, stomach, kidneys, bladder and abdominal wall defects
  • Limbs – confirming presence and movement of arms and legs
What parents see What clinicians assess
Baby’s profile, head, and movements Cranial structure, early detection of acrania or anencephaly, early brain development and evidence of early signs of Open Neural Tube Defects (ONTD’s)

Early facial structures and early detection of facial clefts.

Curved spine on screen Spinal alignment and signs of neural tube defects
Tiny heartbeat flicker Cardiac rhythm, chamber development
Wriggling arms and legs Limb formation, detection of limb reduction anomalies
Abdomen outline Integrity of the abdominal wall, exclusion of exomphalos or gastroschisis
Abdomen Abdominal structures such as the diaphragm, stomach filling, presence of both kidneys, appropriate bladder filling, evidence of 3 vessel cord and cord insertion.

 

For parents, these images are a reassuring sign of normal growth. For clinicians, they provide a vital opportunity to detect significant problems early, allowing for referral to specialist care if required.

Early structural assessment of the fetal brain

Early structural assessment of the fetal brain

3. First Trimester Combined Screening – Chromosomal Abnormality Screening

The 13 week ultrasound can also help assess the risk of chromosomal conditions, such as Down syndrome (Trisomy 21), Trisomy 18, and Trisomy 13.

In the absence of NIPT screening, a First Trimester Combined Screening (FTCS) may be performed to provide a risk assessment screening for Trisomy 21, Trisomy 18 and Trisomy 13 by utilising the risk assessment algorithm provided by the Fetal Medicine Foundation. An early anatomy assessment scan is performed at the same time as the FTCS assessment.

In the event that a NIPT screening has been performed, it has been recommended by ISUOG International Society of Ultrasound in Obstetrics and Gynaecology under the consensus statement that “First-trimester risk estimates for trisomies 21, 18 and 13 based on nuchal translucency measurements and maternal biochemistry should not be computed in a woman who has already received a normal NIPT result for these trisomies” (reference here).

The Fetal Medicine Foundation (FMF) algorithm is a first-trimester prenatal screening method for Trisomy 21 (Down Syndrome) that uses maternal age, fetal nuchal translucency (NT) ultrasound measurements, and maternal serum markers (free beta-hCG and PAPP-A) to calculate a risk score. The algorithm helps identify pregnancies at higher risk for Trisomy 21, but it’s a screening tool, not a diagnostic test, and a higher risk score may lead to further invasive tests like amniocentesis or chorionic villus sampling (CVS).

How the FMF Algorithm Works

  • Maternal Age: Maternal age is a fundamental factor, as the risk of Down Syndrome increases with maternal age.
  • Ultrasound (NT Measurement): A detailed first-trimester ultrasound is performed to measure the nuchal translucency (NT), a collection of fluid at the back of the fetus’s neck.
  • Biochemical Markers: Maternal blood is tested for two hormones:
    • Free beta-hCG (free beta-human chorionic gonadotropin): Typically elevated in Down Syndrome pregnancies.
    • PAPP-A (pregnancy-associated plasma protein-A): Generally lower in Down Syndrome pregnancies.
  • Risk Calculation: The FMF algorithm combines these factors to generate a personalised risk for Trisomy 21, Trisomy 18 and Trisomy 13.

For parents, this part of the scan offers important reassurance or an early signal that further testing may be needed. For clinicians, it provides measurable markers that contribute to first-trimester combined screening.

Markers typically assessed at this stage include:

  • Nuchal translucency (NT): a fluid space at the back of the baby’s neck that, if increased, can indicate a higher chance of chromosomal abnormality.
  • Nasal bone: its presence or absence can be a significant marker in risk assessment.
  • Ductus venosus flow: abnormal flow patterns may be associated with aneuploidy or cardiac defects.
  • Tricuspid regurgitation: when present, it can increase the risk profile.
For parents For clinicians
The scan looks at small features, like the fluid behind the baby’s neck and nose bone, that can indicate a higher or lower chance of conditions such as Down syndrome. NT is measured between 11+0 and 13+6 weeks when CRL is 45–84 mm; when combined with maternal serum biochemistry (free β-hCG, PAPP-A), this forms the basis of first-trimester combined screening.

It is preferred at QUFW to perform this assessment between 13 weeks and 13+6 days

A higher-than-expected NT doesn’t mean something is wrong, but it may lead to follow-up testing for clarity particularly for congenital heart defects or other genetic syndromes. Integration of ultrasound markers with serum and maternal age yields detection rates of >90% for Trisomy 21 at a 5% false-positive rate.

In the event of an NT measurement >3.5mm, further structural assessment of the fetus including the heart for congenital heart defects is made as part of the early anatomy scan.

Results can help guide whether additional tests, such as NIPT or diagnostic procedures (CVS, amniocentesis), are recommended. Ancillary markers (nasal bone, ductus venosus, tricuspid regurgitation) improve specificity and refine risk stratification.

 

In practice, this means the 13 week scan is more than just a “look at the baby” moment. It forms a crucial part of early screening that combines visual markers, blood tests, and clinical context to give the clearest picture possible at this stage of pregnancy.

Nuchal translucency assessment

4. Maternal Health Screening

The 13 week ultrasound is not only about checking the baby, it also provides valuable information about the mother’s health. For parents, this means doctors can look for early signs of conditions that could affect the pregnancy, helping to keep both mother and baby safe. For clinicians, this scan offers an opportunity to assess maternal risk factors and build a plan for ongoing care.

One of the key conditions that can be screened for is preeclampsia, a complication that can lead to high blood pressure and other serious health issues later in pregnancy. At this stage, the scan can be combined with blood pressure readings, maternal history, and blood test results to estimate a woman’s risk. If the risk is found to be higher, preventive steps can be started early.

The scan may also highlight placental concerns. Early assessment of how the placenta is developing and where it is attached provides important insight into how well it might support the pregnancy. These checks give reassurance to parents while helping clinicians take proactive measures if any issues are identified

====================

Content Disclaimer

The information provided on this website is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your obstetric doctor or other qualified provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen.

The content on this website is not intended to be a comprehensive source of information on any particular topic and should not be relied upon as such. The authors and publishers of this website are not liable for any damages or injury resulting from the use or misuse of the information provided on this website.

Viability/dating scans vs. early anatomy scans vs. first trimester combined screening (FTCS) and even “NIPT” (and what to book when)

Viability/dating scans vs. early anatomy scans vs. first trimester combined screening (FTCS) and even “NIPT” (and what to book when)

In early pregnancy, you might hear a range of terms used for the scans you might need, such as “viability,” “dating,” “early anatomy,” or “NIPT.” These names can sound similar, and it’s not always clear how they differ or when each one is recommended.

This fact sheet explains the different types of early pregnancy scans so you can understand their purpose and timing. It answers the following questions:

  1. Overview of first-trimester scans
  2. Dating and Viability scan (around 6–12 weeks)
  3. Early Anatomy scan (13–13+6 weeks)
  4. First Trimester Combined Screening (FTCS) (13–13+6 weeks)
  5. NIPT and its timing
  6. Which scan should I book first?

—————

1. Overview of first-trimester scans

In the first trimester, ultrasound can confirm pregnancy, check wellbeing, and estimate due dates.

Common scans include:

  • Viability and Dating scan – a viability scan or a dating scan refer to the same thing and involve an early check of pregnancy location and heartbeat. The Sonographer measures the fetus to establish or confirm an estimated due date (EDD)
  • Early Anatomy scan – assesses early anatomy and screens for certain structural conditions
  • First Trimester Combined Screening scan – this scan is the same as the Early anatomy scan but provides additional screening for chromosomal abnormalities, particularly Trisomy 21, 18 and 13. The risk assessment is only performed if the patient has not had a NIPT performed. The NIPT has a higher detection rate for Trisomy 21 (almost 99% detection rate) as opposed to approximately 90% detection rate.
  • NIPT (non-invasive prenatal testing) – blood test for chromosomal screening, recommended to be accompanied alongside a viability ultrasound.

Here’s a breakdown of each of these scans:

2. Dating and Viability scan (around 6–12 weeks)

A viability scan confirms that the pregnancy is in the uterus, checks for a heartbeat, and assesses early development. A dating scan measures the crown–rump length (CRL) to estimate gestational age and your EDD. This timing offers a high degree of accuracy (± 5 days). You may be referred for a viability scan if you:

  • Have pain or bleeding
  • Have had an ectopic pregnancy before
  • Conceived via IVF
  • Have a history of pregnancy loss

It also confirms:

  • The baby’s heartbeat
  • Whether you are carrying one baby or multiples
  • The pregnancy location

If performed very early (before 6 weeks), it may be too soon to see a heartbeat, and a repeat scan may be needed.

Dating scan prior to NIPT

Dating scan prior to NIPT

3. Early Anatomy scan (13–13+6 weeks)

The Early Anatomy scan assesses early development and screens for specific structural anomalies. At QUFW we also perform a risk assessment for pre-eclampsia at this scan. The early anatomy scan is performed in conjunction with an NIPT. If you elect not to have NIPT then you will be asked if you would like a risk assessment for Trisomy 21, 18 and 13 (the most common chromosomal anomalies) performed in addition to the anatomical assessment, in which case this then becomes a FTCS (see below).

It also checks:

  • Heartbeat
  • Cervical length assessment
  • Placenta position
  • Multiple pregnancy details

4. If the scan’s EDD differs from your LMP-based date, your healthcare provider will usually use the ultrasound date.

This is the same as an early anatomy scan, however we provide a risk assessment for chromosomal abnormalities like Trisomy 21, 18, and 13. As a screening for Down Syndrome, it has approx. 90% detection rate when combining the following factors such as

  • Maternal age and background risk
  • Ultrasound markers such as nuchal translucency, nasal bone, fetal heart rate
  • Maternal serum biochemistry (Free beta-hCG and PAPP-A)

At QUFW, similar to the Early Anatomy scan we also perform a pre-eclampsia risk assessment as part of this scan.

Nuchal translucency assessment

Nuchal translucency assessment

5. NIPT and its timing

NIPT is a blood test that can be done from around 10 weeks of pregnancy. At QUFW, we prefer to book NIPT’s from 10 weeks 2 days at the earliest.

It analyses small fragments of the baby’s DNA in the mother’s blood to assess the likelihood of certain chromosomal conditions. NIPT does not replace ultrasound which assesses for structural abnormalities.

6. Which scan should I book first?

It depends on your history and how certain you are of your dates:

  • Uncertain LMP or irregular cycles – dating and viability scan between 7–12 weeks
  • History of pregnancy complications – Viability and dating scan from 6 weeks gestation
  • IVF conception – viability scan at 6–7 weeks, then Early Anatomy scan at 13–13+6 weeks
  • Known LMP and no risk factors – dating and viability scan between 7-12 weeks, followed by an Early Anatomy scan. Your GP or specialist will recommend a plan suited to your circumstances.

FAQs

Is a viability scan the same as a dating scan?

A viability and dating scan is essentially the same scan and confirms the presence of a pregnancy in the correct location, if it is a multiple pregnancy and confirms that a heart beat is present. It is also used to either confirm or establish correct dating or due date for the pregnancy.

Do I need both Early Anatomy and NIPT?

A NIPT is a screening test for chromosomal abnormalities. It does not detect structural or developmental concerns with the developing fetus. It is advised that an Early Anatomy scan is performed between 13 – 13 weeks 6 days as a structural assessment of your baby. At QUFW we also perform a Preeclampsia screening as a component of the Early Anatomy scan. A low probability result for a NIPT, does not exclude a structural concern in a pregnancy.

When is the best time for a dating scan?

Between 7 and 12 weeks for best accuracy.

Can an Early Anatomy scan detect all conditions?

No. It screens for certain conditions but not all genetic or structural differences may be detected at this early gestation. A further morphology scan is recommended between 20-22 weeks to reassess the baby.

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