Key Takeaways
- Anomaly scan is done between 18-22 weeks of pregnancy to check baby's organs, growth, and development — the ideal window is 20-22 weeks when organs are most visible
- Around 60-80% of significant physical abnormalities can be identified through this scan, with detection rates above 90% for neural tube defects and abdominal wall defects
- The complete anomaly scan checklist covers 25+ structures across 7 body systems: brain, face, spine, heart, abdomen, kidneys, and limbs — plus placenta, cord, and amniotic fluid
- Anomaly scan price in Dubai ranges from AED 400-1,800 depending on detail level, with 3D/4D add-ons available for AED 300-500
- Soft markers (choroid plexus cysts, echogenic foci, mild pyelectasis) are minor findings seen in 5-10% of scans — most are benign and resolve on their own
- A normal scan is reassuring but does not guarantee the baby will have no medical issues — some conditions develop later or are not visible on ultrasound
An anomaly scan is a detailed ultrasound usually done between 18 and 22 weeks of pregnancy and focuses on the baby's organs, growth, placenta position, and amniotic fluid levels. It can detect many major structural conditions, but it does not find everything. This scan does not diagnose genetic conditions but helps detect visible abnormalities that may need monitoring or further tests.
This guide explains everything expecting parents want to know, including how the scan works, what it checks, the complete 25-item checklist, 2D vs 3D vs 4D comparison, anomaly scan price in Dubai, accuracy, soft markers explained, what happens if something unusual is seen, and follow-up scan options.
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What Is an Anomaly Scan in Pregnancy?
An anomaly scan, also called a level 2 ultrasound, is a detailed pregnancy ultrasound that examines the baby's anatomy from head to toe. Unlike early pregnancy scans that confirm dates or heartbeat, this scan focuses on structure and organ formation.
During the scan, the sonographer checks the baby's brain, spine, heart, kidneys, stomach, limbs, and facial features. The placenta, umbilical cord, and amniotic fluid are also assessed. The goal is to make sure development matches the gestational age and to identify visible structural differences early.
When Is the Best Time for an Anomaly Scan?
The ideal time for an anomaly scan is between 18 and 22 weeks of pregnancy. At this stage, the baby's organs are developed enough to be seen clearly, while there is still enough space for proper imaging.
Scans done earlier than 18 weeks may miss certain findings, while scans done later may be harder due to reduced visibility. Most doctors recommend scheduling it around 20 weeks for the best balance of clarity and accuracy. A prenatal ultrasound at DCDC is performed by experienced specialists using advanced imaging systems to ensure every structure is evaluated thoroughly.
Complete Anomaly Scan Checklist: 25 Structures Assessed
A thorough anomaly scan follows a systematic checklist covering every major body system. This is the complete list of what the sonographer and reporting physician evaluate during the scan, organised by body region:
| # | Body System | Structure Checked | What the Sonographer Looks For |
|---|---|---|---|
| 1 | Brain | Skull shape and integrity | Complete, oval-shaped calvarium with no defects |
| 2 | Brain | Lateral ventricles | Size <10mm bilaterally (dilated = hydrocephalus) |
| 3 | Brain | Cerebellum | Normal shape and size for gestational age (banana sign absent) |
| 4 | Brain | Cavum septum pellucidum | Visible midline structure (absent may indicate brain anomaly) |
| 5 | Brain | Cisterna magna | Depth 2-10mm (enlarged may indicate Dandy-Walker malformation) |
| 6 | Face | Nasal bone | Present and measurable (absent is a soft marker) |
| 7 | Face | Lips and palate | Intact upper lip (to rule out cleft lip) |
| 8 | Face | Orbits | Two orbits present, normally spaced |
| 9 | Face | Profile | Normal facial profile assessed |
| 10 | Spine | Vertebral alignment | Closed vertebrae from cervical to sacral spine |
| 11 | Spine | Skin covering | Intact skin over spine (open = spina bifida) |
| 12 | Heart | Four-chamber view | Four chambers of equal proportion, no defects in septum |
| 13 | Heart | Outflow tracts | Aorta and pulmonary artery crossing normally |
| 14 | Heart | Heart rate and rhythm | 120-160 bpm, regular rhythm |
| 15 | Chest | Diaphragm | Intact (no herniation of abdominal organs into chest) |
| 16 | Abdomen | Stomach bubble | Visible and in correct position (confirms swallowing) |
| 17 | Abdomen | Abdominal wall | Closed, no herniation (rules out gastroschisis/omphalocele) |
| 18 | Abdomen | Bowel | No significant dilation or echogenicity |
| 19 | Kidneys | Both kidneys present | Two kidneys visible, normal size and position |
| 20 | Kidneys | Bladder | Visible and filling/emptying normally |
| 21 | Limbs | Arms and hands | Both arms present with normal movement, hands open |
| 22 | Limbs | Legs and feet | Both legs present, normal length, feet not fixed (clubfoot check) |
| 23 | Placenta | Position and grade | Location noted (low-lying if <2cm from cervix), grade 0-1 at 20 weeks |
| 24 | Cord | Umbilical cord vessels | Three vessels (two arteries, one vein) and normal insertion |
| 25 | Fluid | Amniotic fluid volume | Normal AFI 8-24cm (too much or too little may indicate a problem) |
Complete anomaly scan checklist based on ISUOG (International Society of Ultrasound in Obstetrics and Gynecology) guidelines. Not all structures are equally visible at every scan — baby position affects visualization.
What Does an Anomaly Scan Check For? Week-by-Week Detail
While the checklist above covers all structures, the timing of your scan affects what can be seen most clearly. The best time for an anomaly scan is between 18 and 22 weeks, with the ideal window being 20-22 weeks when organs are well-developed but the baby is still small enough for clear imaging.
What Is Checked at 18-20 Weeks
- Brain structures: lateral ventricles, cerebellum, cavum septum pellucidum, and overall skull shape
- Face: nasal bone, lips (to rule out cleft lip), and profile
- Spine: alignment and closure of vertebrae from neck to tailbone
- Heart: four chambers, outflow tracts (aorta and pulmonary artery), and rhythm
- Abdominal wall: to check for gastroschisis or omphalocele
- Kidneys and bladder: presence, size, and amniotic fluid volume
- Limbs: arms, legs, hands, and feet (counting fingers and toes when visible)
What Is Checked at 20-22 Weeks
At this slightly later stage, more detailed assessment is possible:
- Brain ventricles measured more precisely to detect hydrocephalus
- Four-chamber heart view and major vessel connections assessed in detail
- Diaphragm checked to rule out diaphragmatic hernia
- Stomach bubble visible to confirm normal esophagus and stomach formation
- Placenta position assessed (low-lying placenta or placenta previa)
- Umbilical cord insertion point and number of vessels (should be three: two arteries, one vein)
- Amniotic fluid volume measured to check for polyhydramnios (too much) or oligohydramnios (too little)
If something appears unclear or the baby's position makes visualization difficult, the doctor may recommend a follow-up ultrasound in 1-2 weeks or refer you to a fetal medicine specialist for more detailed assessment.
Normal vs Abnormal Findings: What to Expect
| Structure Checked | Normal Finding | Possible Abnormal Finding | Detection Rate |
|---|---|---|---|
| Brain ventricles | Lateral ventricles <10mm | Dilated ventricles (hydrocephalus) | >90% |
| Heart | Four chambers equal size, normal rhythm | Structural defects (VSD, TOF, HLHS) | 50-70% |
| Spine | Closed, aligned vertebrae | Open spine (spina bifida) | >95% |
| Kidneys | Two kidneys, normal size | Absent, enlarged, or cystic kidneys | >85% |
| Abdominal wall | Closed, organs inside | Gastroschisis or omphalocele | >95% |
| Limbs | All limbs present, normal length | Short limbs (skeletal dysplasia) | >80% |
| Lips | Intact upper lip | Cleft lip | 75-85% |
| Cleft palate (alone) | Intact hard and soft palate | Isolated cleft palate (no lip involvement) | <5% (very difficult to detect on standard ultrasound) |
| Diaphragm | Intact, organs in correct compartments | Congenital diaphragmatic hernia | 60-80% |
| Amniotic fluid | Normal volume (AFI 8-24 cm) | Too much or too little fluid | >95% |
Most babies have completely normal scans. Detection rates are estimates based on published ISUOG data and vary by operator experience and equipment quality.
2D vs 3D vs 4D Ultrasound: Which Is Best for Anomaly Scan?
Parents often ask whether a 3D or 4D ultrasound is better than the standard 2D scan for the anomaly assessment. Each technology has a specific role. For a complete guide to 4D imaging, read our 4D ultrasound during pregnancy guide.
| Feature | 2D Ultrasound | 3D Ultrasound | 4D Ultrasound |
|---|---|---|---|
| Image type | Flat, cross-sectional slices (grey-scale) | Still 3D surface images (depth and contour) | Moving 3D images in real time (video) |
| Primary purpose | Diagnostic — the gold standard for measuring structures and detecting anomalies | Surface anatomy — helps visualize facial features, cleft lip, and limb position | Bonding — real-time video of baby's movements and expressions |
| Medical value for anomaly detection | Essential — all measurements and diagnostic assessments are done in 2D | Supplementary — adds value for surface defects (cleft lip, skeletal anomalies) | Minimal additional diagnostic value — primarily for parent experience |
| Best gestational age | 18-22 weeks (anomaly scan window) | 24-32 weeks (for best surface images) | 26-30 weeks (for best facial features) |
| Typical cost in Dubai (AED) | 400-900 (included in anomaly scan) | 300-500 (as add-on) | 400-600 (as add-on) |
| Available at DCDC? | Yes — standard for all anomaly scans | Yes — can be added to anomaly scan | Yes — available as add-on or standalone |
2D ultrasound remains the diagnostic gold standard. 3D/4D are valuable supplements but do not replace the 2D anomaly assessment.
Important: A 3D/4D scan is not a substitute for a thorough 2D anomaly scan. The diagnostic measurements and organ assessments are all performed using 2D imaging. 3D adds value for visualizing surface anatomy (such as facial clefts or limb abnormalities), and 4D adds the experience of seeing the baby move in real time. At DCDC, the anomaly scan is always conducted using 2D as the primary modality, with 3D/4D available as an add-on for parents who wish to have a more visual experience.
Soft Markers: What Are They and Should You Worry?
During an anomaly scan, the sonographer may note soft markers, which are minor variations that are usually benign but can sometimes be associated with chromosomal conditions when multiple markers are present. Soft markers are found in approximately 5-10% of all pregnancies, and the vast majority of these babies are born completely healthy.
Common soft markers include:
| Soft Marker | What It Looks Like | How Common | Clinical Significance |
|---|---|---|---|
| Choroid plexus cysts (CPC) | Small fluid-filled spaces in the brain's choroid plexus | 1-2% of pregnancies | Usually disappear by 28 weeks. Isolated CPC rarely has clinical significance |
| Echogenic intracardiac focus (EIF) | Bright spot in the heart ventricle | 3-5% of pregnancies | Calcium deposit on papillary muscle. Isolated EIF — very low risk, resolves before birth |
| Echogenic bowel | Bright-appearing intestines on ultrasound | 0.5-1% of pregnancies | May be associated with cystic fibrosis, infection, or chromosomal conditions if persistent — follow-up recommended |
| Mild pyelectasis (kidney dilation) | Renal pelvis >4mm but <10mm | 1-2% of pregnancies | Usually resolves spontaneously. Monitoring with follow-up scans. Significant if >10mm |
| Short femur or humerus | Limb bone below 5th percentile for gestational age | Variable | May reflect normal variation, small build, or (rarely) skeletal or chromosomal condition |
| Single umbilical artery | Two vessels in cord instead of three | 1% of pregnancies | Usually benign when isolated. Associated with higher risk of kidney or heart anomalies — detailed anatomy check needed |
| Absent or hypoplastic nasal bone | Nasal bone not visible or very small | 1-3% (varies by ethnicity) | Associated with increased risk of Down syndrome. Interpretation depends on ethnicity and other markers |
Soft markers are NOT the same as anomalies. Most are normal variations. Your doctor considers the full clinical picture before recommending any additional testing.
In most cases, soft markers are isolated findings that have no clinical significance. If a single soft marker is seen in an otherwise normal scan, the risk of chromosomal abnormalities remains very low. However, if multiple soft markers are present, your doctor may recommend further testing such as amniocentesis or non-invasive prenatal testing (NIPT) to check for chromosomal conditions like Down syndrome.
The majority of babies with isolated soft markers are born healthy. These markers simply prompt closer monitoring and discussion with your obstetrician about whether additional testing is appropriate based on your individual situation.
Book Your Anomaly Scan at DCDC
Detailed 18-22 week anomaly scans performed with advanced GE Voluson ultrasound systems by experienced specialists. 2D diagnostic assessment with optional 3D/4D imaging. Book your prenatal ultrasound at DCDC Dubai Healthcare City.
How Accurate Is an Anomaly Scan?
In general, around 60-80% of significant physical abnormalities can be identified, depending on the condition, baby's position, and scan quality. An anomaly scan can detect many major structural conditions, but it does not find everything.
Detection rates vary by condition. Heart defects are detected in about 50-70% of cases, while neural tube defects (like spina bifida) and abdominal wall defects are detected in over 90% of cases. Cleft lip is often visible, but cleft palate alone (without lip involvement) is very difficult to see on standard ultrasound.
Some issues develop later in pregnancy, and some conditions cannot be seen on ultrasound at all. A normal scan result is reassuring, but it does not guarantee that the baby will have no medical issues after birth. Chromosomal conditions, hearing loss, autism, and many metabolic disorders cannot be detected by anomaly scan. Your gynecologist can advise which additional screenings may be appropriate for your situation.
Is an Anomaly Scan Safe for the Baby?
Yes, an anomaly scan is considered safe for both mother and baby. Ultrasound uses sound waves, not radiation, and has been used in pregnancy care for decades without evidence of harm when performed by trained professionals.
The scan usually takes 30 to 45 minutes, depending on the baby's position and how cooperative they are during the scan.
Anomaly Scan Price in Dubai: Complete Cost Breakdown
Anomaly scan prices in Dubai vary based on clinic location, expertise, level of detail, and whether 3D/4D imaging is included. For a broader overview of pregnancy imaging costs, see our ultrasound cost guide. Understanding what's included helps you choose the right option.
| Type of Scan | Estimated Price (AED) | What Is Included |
|---|---|---|
| Basic anomaly scan (2D) | 400 - 600 | Standard anatomical survey covering all 25 checklist items, basic reporting |
| Detailed anomaly scan (2D) | 600 - 900 | Comprehensive organ assessment, detailed written report, specialist consultation to discuss findings |
| Anomaly scan with 3D add-on | 700 - 1,200 | Full 2D diagnostic scan plus 3D surface images of face and limbs |
| Anomaly scan with 4D add-on | 800 - 1,400 | Full 2D diagnostic scan plus real-time 4D video of baby's movements |
| Follow-up scan (incomplete views) | 300 - 500 | Repeat scan if initial images were unclear due to baby position |
| Specialist fetal assessment | 1,200 - 1,800 | Fetal medicine specialist review for high-risk cases or detected anomalies |
Prices vary across Dubai Healthcare City, Oud Metha, Umm Hurair 2 Dubai, and Karama Dubai depending on facility type and reporting standards.
Most insurance plans in Dubai cover anomaly scans as part of standard maternity care. Daman, BUPA, Cigna, and other major providers typically include one anomaly scan between 18-22 weeks. Check with your insurance provider to confirm coverage and whether pre-authorization is required. DCDC offers direct billing with 20+ insurance providers.
What If an Abnormality Is Found?
If something unusual is seen, it does not always mean there is a serious problem. Sometimes findings are minor, temporary, or unclear due to baby position. Ongoing pregnancy care with your obstetrician ensures appropriate follow-up and support.
The pathway after an abnormal finding depends on the type and severity of what was detected:
Minor or Uncertain Findings
- Repeat ultrasound in 2-4 weeks — many findings (like mild kidney dilation, low-lying placenta, or soft markers) resolve on their own and just need monitoring
- Additional blood tests — your doctor may recommend NIPT or other genetic screening if soft markers increase the risk profile
- More frequent growth scans — if amniotic fluid levels or growth patterns need monitoring
Significant Structural Findings
- Referral to a fetal medicine specialist — for detailed assessment using advanced imaging and expert interpretation
- Fetal echocardiography — if a heart defect is suspected, a specialised cardiac ultrasound of the baby's heart provides much more detailed views
- Amniocentesis — if chromosomal analysis is needed, a small sample of amniotic fluid is tested (discussed in full with you, including risks)
- Multidisciplinary team consultation — involving paediatricians, surgeons, and neonatologists to plan delivery and postnatal care
- Delivery planning — some conditions require delivery at a hospital with a neonatal intensive care unit (NICU) or paediatric surgical team
Early detection allows parents and doctors to plan care, delivery, or monitoring more effectively. DCDC's pregnancy screening services include follow-up scans, growth monitoring, and Doppler assessments to support your care team throughout the remainder of your pregnancy.
Difference Between Anomaly Scan and Other Pregnancy Ultrasounds
Many parents confuse different pregnancy scans. Each has a specific role at different stages. For a closer look at imaging options throughout pregnancy, read about 4D ultrasound during pregnancy and our complete pregnancy scan schedule.
| Scan Type | Purpose | Timing | Cost (AED) |
|---|---|---|---|
| Dating scan | Confirm pregnancy, due date, viability | 6-10 weeks | 200-400 |
| NT scan (nuchal translucency) | Screen risk for chromosomal issues (Down syndrome, Edwards syndrome) | 11-13 weeks | 400-800 |
| Anomaly scan (level 2) | Detailed assessment of all fetal organs and structures | 18-22 weeks | 400-900 |
| Fetal echocardiography | Detailed heart assessment (if anomaly scan suggests cardiac concern) | 20-24 weeks | 800-1,500 |
| Growth scan | Monitor baby's size, weight, fluid, and Doppler blood flow | 28-36 weeks | 300-600 |
| 3D/4D bonding scan | Surface images and video of baby's face and movements | 26-32 weeks | 300-600 |
Timeline of pregnancy ultrasound scans and their purpose. Not all scans are required for every pregnancy — your obstetrician will recommend what is appropriate for your situation.
How to Prepare for an Anomaly Scan
Preparation is simple, but following these tips ensures the best possible imaging and a smoother experience.
Before your appointment:
- Drink 2-3 glasses of water 30 minutes before your scan (moderately full bladder helps with imaging, though less critical at 20 weeks than in early pregnancy)
- Wear comfortable two-piece clothing for easy access to your abdomen
- Bring your partner or support person - they are usually welcome to watch the scan
- Bring previous ultrasound reports if you have them, so the doctor can compare growth and measurements
- Allow 45-60 minutes for the full appointment (the scan itself takes 20-45 minutes depending on baby position)
- Have a light snack before the scan — a baby that is active moves into better positions for imaging
If the baby is in a difficult position (such as lying face-down or curled up), the sonographer may ask you to walk around for 10 minutes or have a snack to encourage movement. Sometimes a follow-up scan a few days later is needed to visualize structures that were initially unclear.
Do not be alarmed if the scan takes longer than expected. A thorough anomaly scan requires patience, and a detailed examination is a sign of good care, not a sign that something is wrong.
Expert Opinion on Anomaly Screening
"The anomaly scan is one of the most important ultrasounds in pregnancy because it allows us to assess all major organ systems at a time when intervention or planning can make a real difference. While most scans are completely normal, identifying structural abnormalities early gives parents time to prepare, consult specialists, and plan delivery at a facility equipped to handle their baby's specific needs. I always encourage parents to view this scan as a routine but important milestone in prenatal care," explains Dr. Parisa Dini, Consultant Obstetrician and Gynecologist at DCDC Dubai Healthcare City.
Anomaly Scan at DCDC: GE Voluson Ultrasound Systems
The quality of an anomaly scan depends heavily on the equipment used and the experience of the sonographer and radiologist. At DCDC Dubai Healthcare City, anomaly scans are performed using GE Voluson ultrasound systems, which are specifically designed for obstetric imaging and are used by leading fetal medicine centres worldwide.
- GE Voluson technology — high-resolution 2D, 3D, and 4D imaging with advanced beam-forming for superior detail in obstetric scanning
- Experienced specialists — anomaly scans performed by trained professionals with specific expertise in fetal anatomy assessment
- Comprehensive reporting — detailed written report covering all 25 checklist items with measurements, sent to your obstetrician
- Clear communication — findings explained to you during and after the scan, with time for questions
- Follow-up coordination — if any findings require additional assessment, DCDC coordinates referrals to fetal medicine specialists
- MOHAP-licensed facility — DCDC holds a 4.8/5 Google rating from over 1,000 verified patient reviews, located in Dubai Healthcare City
Trusted Prenatal Ultrasound in Dubai Healthcare City
At Doctors Clinic Diagnostic Center, we provide detailed pregnancy ultrasound services including anomaly scans, growth scans, and Doppler assessments using GE Voluson systems with comprehensive reporting. Direct insurance billing with 20+ providers.
Call +971 4 270 4870 or WhatsApp to book your anomaly scan
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Frequently Asked Questions
Final Thoughts
An anomaly scan is one of the most important ultrasounds during pregnancy because it offers a detailed look at how your baby is developing at a critical stage. While it cannot detect every condition, it provides valuable reassurance and helps identify concerns early when planning and care options are wider.
Understanding the right timing, the complete checklist of structures assessed, the difference between 2D and 3D/4D imaging, and realistic accuracy expectations helps parents approach this scan with clarity rather than anxiety. Remember that the vast majority of anomaly scans are completely normal, and even when soft markers are found, most babies are born perfectly healthy.
Choosing the right ultrasound provider like Doctors Clinic Diagnostic Center also matters more than many realize — advanced equipment like GE Voluson systems, experienced sonographers, and clear reporting make a measurable difference in detection rates and parent experience. With the right guidance, proper prenatal care, and a trusted provider, this scan becomes a reassuring milestone on your pregnancy journey. For a complete overview of all pregnancy scans and their timing, see our pregnancy scan schedule guide.
Sources & References
This article was reviewed by our medical team and references the following sources:
- Dubai Health Authority - Prenatal Care Guidelines
- Royal College of Obstetricians and Gynaecologists (RCOG) - Ultrasound Standards
- International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) - Practice Guidelines for Performance of the Mid-Trimester Fetal Ultrasound Scan
- American College of Obstetricians and Gynecologists (ACOG) - Ultrasound in Pregnancy Practice Bulletin
- Fetal Medicine Foundation - Second Trimester Anomaly Scan Standards
- NHS - 20-Week Screening Scan (Anomaly Scan)
- Mayo Clinic - Fetal Ultrasound: Why It Is Done and What to Expect
Medical content on this site is reviewed by DHA-licensed physicians. See our editorial policy for more information.
Written by
Dr. Parisa Dini
Consultant Obstetrician & Gynecologist
MD, Obstetrics & Gynecology
Dr. Parisa Dini is a Consultant Obstetrician and Gynecologist specializing in prenatal care and women's health at DCDC Dubai Healthcare City.
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