How many ultrasounds are done during pregnancy?

Prenatal ultrasounds are an important part of monitoring a pregnancy. They allow doctors to check on the growth and development of the fetus, detect potential problems, and gather key information to help ensure the health of both the mother and baby.

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Typical Ultrasound Schedule During Pregnancy

The number of ultrasounds conducted during a typical pregnancy can vary based on several factors, but there is a general ultrasound schedule that is recommended by medical organizations like the American College of Obstetricians and Gynecologists (ACOG).

Here is an overview of the standard number of ultrasounds during a normal, low-risk pregnancy:

Ultrasound Type	Recommended Timing	Purpose
First trimester ultrasound	11-14 weeks	Confirm due date, detect multiples, check fetal development
Second trimester anatomy scan	18-22 weeks	Check fetal anatomy for potential abnormalities
Third trimester growth scan	28-32 weeks	Assess fetal growth, position, amniotic fluid volume

Based on these recommendations, most healthy pregnancies involve having at least 3 ultrasounds throughout the 9 month gestation period. However, some women may have additional ultrasounds recommended by their doctor for specific reasons.

Reasons for Additional Ultrasounds

While 3 ultrasounds are usually standard, there are various medical reasons why a patient may need to have more ultrasounds during their pregnancy. Common reasons for extra ultrasounds include:

Confirming gestational age and due date if there is uncertainty
Follow-up to assess fetal development if an abnormality is suspected
Checking placental location for suspected placenta previa

Monitoring fetal growth issues such as intrauterine growth restriction
Checking amniotic fluid levels if too much or too little fluid is present
Checking cervical length in women at higher risk for preterm labor

Re-checking anatomy if the baby was in an awkward position at the time of the anatomy scan
Assessing condition of baby and placenta after a motor vehicle accident
Monitoring blood flow with Doppler ultrasounds for high-risk conditions

In these situations, it is common for women to receive one or more additional ultrasounds beyond the standard amount. The exact number will depend on the specific medical circumstances.

Are Too Many Ultrasounds Harmful?

Most women can safely undergo ultrasounds during pregnancy as needed. However, having more ultrasounds than necessary without a clear medical reason is not recommended.

Some key points about the safety of excessive prenatal ultrasounds:

Experts believe ultrasounds are safe when used as directed, with no known harm to mother or baby from typical scans.
Heating effects of ultrasound have not been shown to cause problems when scans are performed by trained professionals using proper technique.
Very frequent, lengthy, unnecessary ultrasounds may cause tissue heating, so doing more scans than needed is not advised.

No definitive link has been found between ultrasounds and childhood conditions like autism in large, high-quality studies.
Non-medical ultrasound sessions solely to provide keepsake photos have raised safety concerns and are discouraged by the FDA and medical organizations.

Talk to your doctor about the appropriate number of ultrasounds based on your specific pregnancy needs. Follow the advice of your obstetric provider to avoid unnecessary overuse of ultrasound.

First Trimester Ultrasounds

Getting an ultrasound in the first trimester is standard prenatal care. Here’s what to expect with first trimester ultrasounds:

Timing: Between 11-14 weeks is ideal, but can be done anytime from 6-12 weeks as needed.
What It Checks: Confirms the fetus is alive, evaluates the gestational age and expected due date, checks for multiples, and assesses anatomical development.

How It’s Done: A transducer is moved over the abdomen or inserted vaginally to obtain views of the uterus, ovaries, and developing embryo/fetus.
Length of Appointment: 30-45 minutes is typical.
Determine Due Date: Using the crown-rump length, gestational age is estimated within 3-5 days accuracy in the first trimester.

This foundational ultrasound provides important data to date the pregnancy and rule out issues needing quick attention. For those planning a first trimester ultrasound, knowing what to expect can provide peace of mind that the pregnancy is progressing normally.

Second Trimester Anatomy Ultrasounds

The second trimester anatomy scan is considered one of the most important ultrasounds during pregnancy. Details on what it involves:

Timing: 18-22 weeks is the target, typically around 20 weeks.

What It Checks: Evaluates fetal anatomy from head to toe, screening for potential abnormalities.
How It’s Done: Transabdominal ultrasound visualizes all organs; transvaginal can provide clearer images if needed.
Length of Appointment: 30-60 minutes depending on difficulty visualizing anatomy.

Screening Tool: Helps identify possible anatomical defects like spinal issues, heart or kidney problems, or limb abnormalities.

The mid-pregnancy anatomy ultrasound is like getting a snapshot of what is going on inside the womb. Although not definitive, it provides valuable insight into fetal development and can help parents-to-be breathe easier.

Third Trimester Growth Ultrasounds

In the last trimester, ultrasounds mainly focus on measuring growth and well-being. What to expect with third trimester ultrasounds:

Timing: Typically done between 28-32 weeks, may be done monthly in high-risk pregnancies.
What It Checks: Fetal size and growth, amniotic fluid level, placental appearance, fetal position.
How It’s Done: Transabdominal ultrasound visualizes fetus; transvaginal can give more detail if necessary.

Length of Appointment: 15-30 minutes depending on reason for exam.
Track Growth Patterns: Serial ultrasounds can track changes in fetal size indicative of issues like restricted growth or macrosomia.

Monitoring fetal growth in the third trimester helps providers best manage labor plans, medication dosing, and timing of delivery for optimal newborn outcomes.

Specialized Prenatal Ultrasounds

In addition to routine ultrasounds, specialized scans may be used in specific circumstances. These include:

Early Viability Ultrasounds: Confirm a uterine pregnancy versus ectopic pregnancy as early as 4-5 weeks gestation.
NT Ultrasounds: Done in conjunction with blood tests to screen for chromosome defects like Down syndrome.

Cervical Length Ultrasounds: Check cervical shortening in women at high risk of preterm birth.
Biophysical Profile: Combines ultrasound with fetal heart rate monitoring to assess fetal health.
Doppler Ultrasounds: Use sound waves to evaluate blood flow in the umbilical cord, placenta, or fetal organs.

These ultrasounds require specialized training and are not part of routine prenatal scans. They provide added insight when medically indicated by increased risk factors.

Keepsake Ultrasounds

Some pregnant women opt to get additional ultrasounds at ultrasound boutiques to create personal keepsake videos and photos of their baby. However, the FDA and OBGYN groups warn against the practice citing safety concerns and lack of regulation.

Points to consider about keepsake ultrasounds:

No medical benefit when standard scans are already being done.
FDA does not approve ultrasounds for creating souvenir videos/pictures of the fetus.
Technicians may lack training to perform medical ultrasounds safely.

Overexposure to ultrasound waves raises theoretical risks.
Photos/videos cannot confirm anatomy is normal or diagnose problems.

The convenience and excitement of additional photos and videos is understandable. However, non-medical ultrasounds provide no clinical benefit and should be avoided without a doctor’s recommendation.

Ultrasound Costs

The costs of pregnancy ultrasounds can range widely depending on several factors:

Location of Care: Hospital ultrasounds usually cost more than those performed at imaging centers.
Type of Ultrasound: More specialized scans often have higher fees.

Insurance Coverage: Out-of-pocket expense is higher for patients with plans involving copays or deductibles.
Geographic Location: Average costs in certain areas are higher based on regional healthcare expenses.
Provider Rates: Large hospital systems tend to charge more than private clinics or independent radiology groups.

On average, first trimester ultrasounds cost $200-$300, second trimester anatomy scans $250-$500, and third trimester scans $200-$300. Prenatal ultrasound costs can range from approximately $100 up to $1000+ in some areas.

Saving on Prenatal Ultrasound Costs

Here are some tips to minimize the costs of medically necessary pregnancy ultrasounds:

Use in-network imaging facilities when possible to pay lower rates.

Ask if discounts are offered for paying in cash versus billing insurance.
Seek providers like midwives who include ultrasounds as part of global maternity fees.
Compare prices between hospital and stand-alone imaging centers.

Avoid boutique ultrasound clinics and additional discretionary scans.

Checking with your insurance plan and asking questions upfront can potentially help pare down your out-of-pocket ultrasound costs during pregnancy.

Are Ultrasounds Necessary?

Ultrasounds during pregnancy provide valuable medical benefits that are considered by most experts to outweigh any theoretical risks. The advantages include:

Confirming normal embryonic/fetal development.
Screening for potential anatomical abnormalities.
Checking placental location to rule out placenta previa.

Identifying multiple gestations.
Estimating gestational age, delivery date, and fetal weight.
Assessing amniotic fluid and growth.

Guiding medical decisions and delivery plans.
Reducing need for invasive testing through improved diagnosis.

Given these demonstrated benefits, ultrasound is considered a safe, helpful tool in managing pregnancy when used appropriately. Like any test, it has limitations, but the information it provides aids provision of optimal prenatal care.

Alternatives to Ultrasound

There are limited alternatives to ultrasound for monitoring pregnancy:

Pelvic exam – Can estimate uterus size but provides little info about the fetus.
Amniocentesis – Invasive procedure to sample amniotic fluid for genetic testing.

Non-stress test – Tracks fetal heart rate but does not visualize anatomy.
Fundal height measurement – Only estimates fetal growth and gestational age.

These procedures have significant drawbacks compared to ultrasound. When performed correctly, ultrasound provides important pregnancy monitoring at no known risk to mother or baby.

Conclusion

The number of ultrasounds considered standard during a low-risk pregnancy is about 3 spaced out through the trimesters. Specific indications like uncertain dates, placental issues, fetal growth concerns, or monitoring high-risk conditions can prompt additional ultrasounds as needed under a doctor’s care. While ultrasounds should not be overused without cause, they remain an invaluable tool for monitoring prenatal health and development when utilized properly.