During the second trimester, one of the vital and necessary pregnancy ultrasound scan is the Anomaly scan or TIFFA scan (Targeted Imaging for Fetal Anomalies). This is usually done within 18 to 20 weeks of gestational age. This scan targets checking the baby's physical development, growth, and how the baby is doing and detecting the abnormalities, if any. Read this article to learn more about an Anomaly scan or TIFFA scan, its meaning, importance, schedule, and report.
When : 18 to 20 weeks of pregnancy
Why : To examine any structural problem from head to toe
What is checked : Checks baby's heartbeat, physical development, structural abnormality, down syndrome conditions and congenital heart defects. Closely examines the fetus and uterus, position of placenta, the umbilical cord, and amniotic fluid around the fetus.
In this article
Congratulations on having successfully completed your first trimester. Your baby, by the end of the first trimester, has not only graduated from an embryo to fetus but has also developed 90 percent of adult-like anatomical structures. While we welcome you to your second trimester, we want to make sure that this journey turns out to be an easier, encouraging, and enjoyable one for you.
Your baby goes through significant changes during the second trimester. The internal organs have been formed and continue to mature during this time. Therefore, a regular visit to the obstetrician and following it up with the prescribed checkups and scans is crucial for the healthy growth and development of the fetus. Any form of abnormality in the mother or the child is detected at this stage.
Out of all pregnancy ultrasound scan, the most critical second-trimester scan is the anomaly scan, also known as the TIFFA scan. TIFFA stands for Targeted Imaging for Fetal Anomalies. This scan checks everything from your baby's heartbeat to its physical development. This article discusses detailed information about Anomaly scan or TIFFA scan, its meaning, importance, reports, and some underlying questions about the same.
What is anomaly scan or TIFFA scan
An anomaly scan or TIFFA scan (Targeted Imaging for Fetal Anomalies) is the most critical scan carried out in your second trimester. This pregnancy ultrasound scan is also referred to as a 20 week ultrasound scan or Level II ultrasound scan. This ultrasound scan is usually done between 18 to 20 weeks of pregnancy. Still, it can be performed up to 22 weeks of gestational age.
The scan closely examines the fetus and your uterus, your baby's health, growth, and development. Any deformity, if present, is detected in the anomaly scan, although it might not pick up every condition. The scan gives side views of the fetus using 2D black and white images. 3D or colour images are also used. You can ask the sonologist for your baby's pictures or film the entire video and bring back a CD or DVD for your home.
What is best time to schedule and perform anomaly scan or TIFFA scan?
Though this pregnancy ultrasound scan can be performed anytime during the 18 to 22 weeks of pregnancy, it is best to perform it within the 18 to 20 weeks of conception. According to The Medical Termination of Pregnancy Act 1971, abortion can be performed up to 19 weeks and 6 days of conception. Hence, if there is any severe complication noticed in the baby in an anomaly scan, the parents, if decides, can terminate the pregnancy. This helps to mitigate further complications for the mother's health.
Another reason to perform this scan within 18 to 20 weeks of pregnancy is the growth of your baby. By the 19th week, the baby is around 6 inches long and develops the anatomical structures like an adult, so any structural abnormality can be best picked up at this stage. The internal organs start to grow and mature. The brain develops millions of motor neurons. You might begin to feel your baby moving inside your uterus. 19 to 20 weeks is the best gestational age suggested by the obstetrician for the anomaly or TIFFA scan.
Importance of anomaly scan or TIFFA scan and why to go for it?
The anomaly scan or the TIFFA scan examines the fetus from head to toe monitoring the overall growth, development, and health. The sonographer checks the baby's anatomy and examines any structural problem from head to toe. The scan can measure the size and weight of the fetus. It also looks at the position of your placenta, the umbilical cord, and amniotic fluid around the fetus. Any abnormal positioning of the placenta might result in miscarriages or heavy bleeding during pregnancy and can cause many complications to the mother and the baby.
The anomaly scan or 20 week ultrasound scan is significant as it records any deformity in the fetus. Although certain anomalies cannot be detected during sonography, about 50% of down syndrome conditions and congenital heart defects are detected. There can be cases where the baby's organs are not developed properly. In some cases, there can be some abnormalities that cannot be treated after the baby's birth. Some may lead to the death of the fetus during the remaining pregnancy or immediately after the birth. All this needs to be detected, examined, and studied. So this scan is critical so that your obstetrician can suggest the necessary actions, medications, and reassurance about your baby's health during the remaining part of pregnancy.
What baby details can be found from an Anomaly scan or TIFFA scan?
This pregnancy ultrasound scan looks closer to every detail of your child's normal and healthy development. The scan can identify severe abnormality conditions in the fetus. However, not all deformities can be analyzed from the Anomaly scan. Your baby may look perfectly healthy and normal in the scan yet be born with abnormalities. Some of the conditions detected are:
Edwards’ Syndrome (Trisomy 18) (95%)
Patau’s Syndrome (Trisomy 13) (95%)
Bilateral Renal Agenesis (84%)
Cleft Lip (75%)
Open Spina Bifida (90%)
Diaphragmatic Hernia (60%)
Lethal Skeletal Dysplasia (60%)
Down Syndrome (50%)
Congenital Heart Disease (50%)
How the anomaly scan or TIFFA scan is done?
The scanning process occurs quickly, painlessly, and skillfully by trained medical professionals. At first, the sonographer or the radiologist will apply the gel all over your abdomen. Then, a handheld probe moves it across the area to be examined. The gel used allows good contact between the probe and your skin.
You will see pictures of your baby on the ultrasound screen. Often, to get clear images of your baby, the sonographer might give a little pressure on your abdomen while moving the probe, which might be a little uncomfortable. Still, it is absolutely safe and done with caution.
The entire procedure takes around 30 to 40 minutes. But it can be delayed if your baby is moving a lot or if a sonologist couldn't examine any part in detail due to the baby's position. Sonologist may ask you to wait for some more time until the baby gives the correct position or call you back some another day to examine it. There's nothing to worry about. Just lie comfortably and enjoy the entire process. Yes, one of the most incredible and most beautiful emotional moments you will be experiencing and taking back home is the picture of your baby. Following are a few things to take care of while visiting the sonologist for an anomaly scan:
Carry your obstetrician's prescription of sonography advised.
Carry your previous Ultrasound scan reports. The doctor may want to see them before performing the anomaly scan.
You do not need to be with a full bladder for an anomaly scan.
Take out proper time while going for an anomaly scan. This scan may take more time than other scans, so do not hurry.
Is it necessary to take the anomaly scan or TIFFA scan?
The Anomaly scan or TIFFA scan is one of the most crucial pregnancy ultrasound scan. This scan is done to see the growth and position of the fetus and detect disabilities if any. This scan helps to detect the abnormalities and, in some extreme conditions, enables you to decide to continue the pregnancy. As many of the pregnancy checkups and treatments are the mother's personal choice, this one is also a personal choice. But this scan is highly recommended by all pregnancy doctors. Consult your obstetrician if you have any questions on the importance and necessity of this scan.
When do I receive my anomaly scan report or TIFFA scan report?
The report of an anomaly scan is quite detailed. The report may include important information about your baby, its health conditions, overall growth, size, and progress. It also contains details about the baby's internal organs and their normal and proper development status. The report includes positioning the placenta and recording any major and minor abnormalities in the fetus or the mother. You should be able to receive the report of your anomaly scan or TIFFA scan, usually on the same day. Even if there is some delay in getting the report, you need not panic. Some reports may take time to understand the detected anomalies and make the correct diagnosis. Talk to your obstetrician if there is any delay and feel a little worried.
What happens if any abnormality of the baby is detected in the report?
In most cases, the fetus develops normally, and no complications are recorded. In case of any anomaly noticed in the anomaly scan or TIFFA scan, the sonographer will ask you to take a second scan. Lesser severe abnormalities can improve with time, or surgeries can be provided once the baby is born. Whereas, in case of severe anomalies, the family is given care, support, and information about other processes, including termination of pregnancy and the appropriate time for the action.
Moreover, it is to be remembered that there are cases when no abnormality is recorded in the scan. Yet, the baby is born with an undetected anomaly. There are also cases where fetuses showing certain complications during pregnancy are born perfectly healthy and normal. Therefore, don't panic or be heartbroken if any problem is detected. Firstly, we advise you to discuss it with your obstetrician before settling on a solution. Then, the final decision is solely that of yours.
A girl, when bleeds, transform into a woman. A woman is then blessed to bring life in her womb, to nurture a soul, and in doing so, she becomes a mother, an unconditional love giver. Conceiving a child, perhaps undoubtedly, the most precious gift for a woman and the entire chapter of one's pregnancy from the first to the third trimester is essentially crucial. Therefore, one must rigorously follow the routine checkups and scans that her obstetrician or gynecologist recommends.
The journey from an embryo till the wonder is born is typically nine months. Still, it serves one of the best and greatest phases of her life to rejoice forever. Therefore, we wish every mother to enjoy this unique and sublime ride of her life and celebrate it cheerfully. It is impertinent to take care of yourself and your baby. Hence, following the correct medications, proper diet, regular checkups, and prescribed scans is crucial during pregnancy. An anomaly scan or TIFFA scan is one such important scan of the 18 to 20 weeks of gestational age. This scan checks everything from your baby's heartbeat to its physical development. Including it as a part of the second trimester of your pregnancy journey is advised by most doctors. If you have any questions about this, visit the obstetrician or feel free to ask me any questions.
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Dr. Varshali Mali is an Obstetrician and Gynecologist. She did her MBBS from Dr. D. Y. Patil Medical College, Pune, DNB (Obstetrics & Gynecology) from Jehangir Hospital, Pune, and Diploma in Gynecological Endoscopy from the University of Schleswig Holstein - Kiel Germany. She has several years of experience working as a gynecologist, pregnancy doctor, and lecturer. Through her clinic located at Life Republic township near Marunji, she provides gynecology and pregnancy care solutions to the women around Hinjewadi, Wakad, and nearby Pune. She is known for her welcoming nature, smiley face, supportive attitude, intelligence, and in-depth knowledge about gynecology and pregnancy in her patient community. Mother of two daughters, she believes that motherhood is the best gift one can get. As her contribution, she puts her best efforts into making the pregnancy journey most enjoyable for her patients.