Pregnancy ultrasound is mainly performed transabdominally, as there is more control over the views, and it is less invasive of your privacy. For specific reasons a transvaginal ultrasound may also be required. This comes up most often in very early stages of pregnancy such as finding a heartbeat, but occasionally arises at any stage, such as the length of the cervix or the lower edge of the placenta, in circumstances where this information will be more precise by the vaginal approach. If so, the reason/benefit will be explained.

We welcome close family and/or a friend. Even if there are any concerning findings, it is helpful to have extra support, and another person can help take in information. Although we try to make the scan experience as agreeable as possible in many ways, we still have a lot to concentrate on, so if you want to involve a large people, we suggest you should accept a DVD and share it with them later.

We can provide a live/moving DVD of much of the scan at no extra cost with both the 19-week anatomy scan and the 12 week scan, not at other scans. You will still receive prints at other times in the pregnancy

We can usually get some favourable 3D/4D views at your routine 19 week ultrasound, but the medical information is more accurate in 2D (real-time) ultrasound since the information is more concentrated, so most of the scan is performed in this. If 3D/4D is obtainable at later stages of pregnancy, these can be impressive, but at the time most late referrals are made for medical reasons, it is not always a good time for 3D pictures. See our section on 3D – 4D Ultrasound

A few days makes a big difference to what you and we can see at this stage of pregnancy, and you will feel more satisfied with your scan if keep to the recommended timing, 12 to 12 ½ weeks, or 13 weeks if you have already had an earlier ultrasound. This way some early anatomy checks may be achieved, and if the dates are different to those predicted from your period, screening can usually still be performed. If there is a good reason to alter the timing, such as bleeding, or you are over 35 years old and worried about an increased risk of problems, by all means this can be taken into account.

The 19 week ultrasound is timed to be late to check the baby (fetus) thoroughly, but not so late that options are closed if problems are found. The timing usually can be flexible if there is a good reason. For example if you or your partner work fly-in fly-out, or you are overweight so do not scan well, then if may be preferable to have the ultrasound slightly later. In Western Australia, there is a legal limit on pregnancy decisions at 20 weeks, after which a committee is involved.

For gynaecological ultrasound, a vaginal ultrasound adds extra important detail to almost all scans, but abdominal ultrasound is still a good overview, so we expect to use both. However we understand that there are women for whom vaginal ultrasound is not appropriate, and no one is forced into any ultrasound approach they are fearful of. Vaginal ultrasound is typically an easier examination than a Pap smear. If you do not think vaginal ultrasound would be performed, the bladder filling becomes more important.

There is no doubt that ovarian cancer is serious enough to offer tests. The problem is that the available tests are not reliable for screening. The forms of screening which are currently available are (1) a blood test and (2) ultrasound. The blood test is readily available but only half of women with early cancer (the stage to catch it at for the best chance of a cure) have an abnormal blood test result. Even when the blood test comes back abnormal, it is not usually due to cancer, but a lot of anxiety is experienced while waiting for tests and results. Ultrasound can show ovarian cancer, but this again is only really useful for screening if it is detected while confined to an ovary. Extensive research has shown that some ovarian cancers can spread while the disease is still microscopic (before it is visible with ultrasound or even the eye at surgery). Also when ultrasound shows something worrying, this can require an operation to sort it out. The research shows that each case of saving a woman’s life from cancer has not justified the number of operations (with their own risks and inconvenience) that are required in healthy women who turn out to have no cancer. A lot of work is being done in huge studies around the world to improve screening, and at some stage a whole panel of blood tests will be available as a first step, with ultrasound as back-up if the blood test is abnormal. In the meantime, screening is not recommended for women who have no family history and are not unduly anxious. For those who want screening despite the lack of proof of effectiveness, it is reasonable to have either a blood test, an ultrasound or both. If you have both, the blood test should be ahead of the ultrasound so that raised blood tests can be addressed at the same time. However it is important to understand, the best a normal ultrasound can be said to provide, is reassurance of a lower incidence of ovarian cancer within a year.