Pregnant over 35: Here's What Your 20-Week Ultrasound Can Show You


Finding out the sex of your baby is an exciting milestone, but what else can the 20-week ultrasound reveal? The ultrasound looks at your baby’s development head to toe, inside out. At this point, you can expect information about the baby’s growth, position and health.

For moms over 35, there are some additional questions you may want to ask your doctor.

Four Questions to Ask at the 20-Week Ultrasound

Are the baby’s organs growing normally?

From the scan, the sonographer will examine the following about your baby’s growth:

  • Weight and length: The baby should weigh around nine ounces and reach the length of eight inches.
  • Face: The baby’s lips form between the fourth and seventh weeks of pregnancy. A doctor will screen defects such as cleft lip, an opening on one side or both sides of the lip. It is estimated that approximately 4,440 babies are born with cleft lip—with or without cleft palate, according to the Centers for Disease Control and Prevention (CDC).
  • Brain: Conditions affecting the brain, such as anencephaly, are rare, but feel free to ask your doctor if everything is okay.
  • Spine: A normal baby should have a spine with all bones aligned. At this point, the ultrasound can pick up spina bifida, also known as cleft spine. It is one of the most common neural tube defect in the US, says the National Institute of Neurological Disorders and Stroke.
  • Heart: The baby should have two top chambers and two bottom chambers. A normal heart rate for a baby ranges from 120 to 160 beats per minute.
  • Kidneys: A baby at 20 weeks should have two kidneys.
  • Limbs: At this stage, the baby’s legs, arms, fingers and toes should be fully formed. The ultrasound can show limb malformations or missing limbs.

Is the placenta still healthy?

In early pregnancy, low placenta is not a problem. Typically, the issue resolves as the baby grows and your uterus expands and pulls the placenta upwards.

However, if your placenta remains low in the womb, this could be a sign of placenta previa, which means the placenta is located in the lowest part of the uterus. The placenta can block the birth canal opening, causing complications during delivery.

This condition occurs in 1 out of 200 pregnancies, and it is more common among women who start pregnancy at an older age, according to the US National Library of Medicine.

Are there any signs of down syndrome?

Our physicians recommend doing a Down syndrome screening even if no one in your family has the condition. Only a small percentage of people with Down syndrome inherit it. If your family has a history of Down syndrome, please inform your doctor.

To perform an accurate screening with a detection rate of 90 to 95 percent, the doctor should also screen during the first 12 weeks of pregnancy. However, if any of the following signs are detected in the 20-week ultrasound, your physician may prescribe additional tests to make a diagnosis:

  • An increase in the skin behind the baby’s neck
  • Heart defects
  • Intestinal blockages

Maternal age and Down Syndrome risk

Should I worry if anything abnormal shows in the ultrasound?

Ultrasounds alone are not the most reliable for making an accurate diagnosis. Sometimes, the baby was not in a good position during the scan.

If the physician suspects a problem from your ultrasound, she will order further tests to have a detailed look at the baby’s development.

The 20-week ultrasound can reveal valuable information about your baby’s health and development. Together, you and your doctor can make sure your baby is getting the right care.

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