The anomaly scan (also called the 20-week scan, TIFFA scan, or morphology scan) is a detailed ultrasound performed between 18 and 22 weeks of pregnancy. It checks 70+ fetal structures including the heart, brain, spine, kidneys, limbs, face, and placenta. At Mother Hospitals, Boduppal, Hyderabad, the anomaly scan is part of the comprehensive antenatal programme — with results explained personally by Dr. E. Prashanthi Reddy. Call 97059 93366 to book.
Comprehensive TIFFA scan checking 70+ fetal structures at 18–22 weeks. Brain, heart, spine, kidneys, face, limbs, placenta — nothing missed. Expert obstetric sonography by Dr. E. Prashanthi Reddy. Mother Hospitals, Boduppal, Hyderabad.
MBBS · DGO · PG Diploma in ART — Kiel University, Germany
20+ Years Experience · TGMC Reg: 50624 · 10,000+ Families
The anomaly scan is the most detailed ultrasound of pregnancy. It goes far beyond confirming the baby is alive and growing — it systematically examines every major organ and structure to check that development is proceeding normally.
TIFFA stands for Targeted Imaging for Fetal Anomalies. The name describes exactly what this scan does — it targets specific fetal structures according to a structured protocol, looking for anomalies (abnormalities) in each one. In India, "TIFFA scan" and "anomaly scan" are used interchangeably, and refer to the same detailed second-trimester ultrasound.
Other names you may hear for the same scan:
Regardless of what it is called locally, the content and purpose are the same: a complete assessment of fetal anatomy at 18–22 weeks of pregnancy.
The anomaly scan is considered the most important routine pregnancy scan because 18–22 weeks is the optimal time in pregnancy for detailed structural assessment. By this stage:
FOGSI (Federation of Obstetric and Gynaecological Societies of India) and ICMR recommend the anomaly scan as a standard component of routine antenatal care for all pregnant women in India. It is not only for high-risk pregnancies — structural abnormalities can occur in any pregnancy, including first pregnancies in young healthy women with no known risk factors.
The anomaly scan detects approximately 60–70% of major structural abnormalities when they are present. Some conditions are not visible on ultrasound, and some very subtle findings may only become apparent in the third trimester — but the 20-week scan remains the single most important detection tool available during pregnancy.
The anomaly scan is most informative between 18 and 22 weeks. Before 18 weeks, some structures (particularly the heart) may not be clearly visible. After 22 weeks, the baby's head begins to engage in the pelvis and the scan becomes technically more difficult. The sweet spot is 20–21 weeks for most women — book now to secure an appointment in the optimal window.
The timing of the anomaly scan is important — too early and key structures cannot be clearly seen; too late and the scan becomes technically difficult. Here is why 18–22 weeks is the internationally agreed window.
At 18 weeks, the baby is large enough for detailed visualisation of all major structures, but the amniotic fluid volume is at its highest relative to baby size — giving excellent ultrasound windows from multiple angles. The fetal head is not yet deeply engaged in the pelvis, the skull bones are not fully calcified (so brain structures are clearly visible), and the heart chambers are large enough to evaluate all four chambers and the major outflow vessels.
By 22 weeks, some women (particularly those with a low-lying placenta or a baby in an awkward position) may find that certain structures become harder to image. After 24 weeks, bony calcification increases and the skull becomes a barrier to intracranial imaging. Some centres extend the window to 24 weeks if a repeat scan is needed, but 20–21 weeks is universally considered ideal.
For most women, 20–21 weeks gives the best compromise between image quality and timing. Women with specific risk factors (such as diabetes, family history of cardiac defects, or elevated NT) may be offered an anomaly scan at 18–19 weeks to allow more time for further specialist referral if needed.
Women who are overweight or who have had previous scans where the baby was in a difficult position for imaging are sometimes scanned a little later (21–22 weeks), when the baby may be slightly larger and easier to turn with gentle maternal repositioning.
At Mother Hospitals, Dr. Prashanthi will advise the best timing for your specific pregnancy at your mid-pregnancy antenatal appointment.
The TIFFA scan follows a structured checklist of over 70 fetal structures — here is a system-by-system breakdown of what is assessed at Mother Hospitals.
The anomaly scan does not detect every possible condition — approximately 30–40% of structural abnormalities may not be visible at this stage, particularly minor cardiac septal defects, small cleft palates, and minor limb differences. A normal anomaly scan is very reassuring but is not a guarantee of a structurally perfect baby.
Most couples find the anomaly scan one of the most memorable appointments of pregnancy — seeing the baby's face, hands, and heartbeat in detail. Here is exactly what to expect.
The anomaly scan requires minimal preparation:
You will be asked to lie on the examination couch and the sonographer/doctor will apply warm gel to your abdomen. The ultrasound probe is moved systematically across the abdomen in a structured sequence:
If the baby is in an awkward position, you may be asked to cough, walk around, lie on your side, or wait a few minutes to encourage the baby to move. This is normal and does not indicate any problem.
At Mother Hospitals, standard 2D ultrasound is used for the formal anomaly scan assessment — 2D imaging provides the most accurate measurements and the clearest structural detail for diagnostic purposes.
3D/4D imaging (which produces surface-rendered face and body images) may be offered as an additional view once the formal examination is complete. These images are wonderful for parents to see the baby's face and expressions — but they are supplementary to the clinical assessment, not a replacement for it. The diagnosis is always made on 2D imaging.
A complete anomaly scan typically takes 30–45 minutes of scanning time — longer than any other routine pregnancy ultrasound. The heart is particularly time-consuming because the baby must be in the right position for the outflow tract views. If the baby is facing the wrong way or sleeping in a position that limits access, the total scan time may be extended.
Please plan for a 45–60 minute total appointment, including registration, the scan itself, and the results discussion with Dr. Prashanthi. Rushing the anomaly scan risks missing important findings — thoroughness is more important than speed at this stage.
Yes — partners and support persons are warmly welcome at the anomaly scan. This is one of the most significant appointments of your pregnancy, and having your partner or a family member with you makes the experience more meaningful. Please let us know when booking if you plan to bring someone so we can ensure appropriate space.
The vast majority of anomaly scan results are normal and reassuring. When a finding is made, understanding what it means helps you respond with clarity rather than anxiety.
A normal anomaly scan report means that all visualised structures appear within normal range for gestational age. This is the most common outcome — the large majority of women have a completely normal anomaly scan. A normal report is highly reassuring and means routine antenatal care continues.
Dr. Prashanthi will explain the normal findings systematically at the end of the scan — not simply say "everything is fine" but walk through what was seen. This gives you confidence that a thorough examination was completed.
Important caveat: a normal anomaly scan does not mean the baby is 100% structurally perfect. Some conditions are not detectable on ultrasound (minor chromosomal conditions, metabolic disorders, some cardiac septal defects), and some findings only become apparent later in pregnancy. The anomaly scan is the best tool available, not a perfect one.
Soft markers are ultrasound findings that are variants of normal but are more common in babies with chromosomal conditions such as Down syndrome. They do not diagnose any condition — they modify the risk probability. Common soft markers include:
If a soft marker is found, Dr. Prashanthi will explain its significance clearly. In isolation with a low-risk first-trimester screen, most soft markers require only monitoring — not immediate invasive testing. NIPT may be offered to provide further reassurance.
When the anomaly scan finds a significant structural abnormality, it can be an extremely difficult moment. At Mother Hospitals, Dr. Prashanthi will:
Finding a structural abnormality does not always mean a severe outcome. Many conditions found on the anomaly scan are mild and manageable — some resolve spontaneously, some require treatment after birth, and some are best monitored throughout pregnancy. The next step is always further assessment to understand the full picture before any decision is made.
A repeat anomaly scan is sometimes recommended for reasons that are not related to an abnormality:
These are two completely different scans, done at different stages of pregnancy for different purposes — both essential.
Both scans are essential and complementary — neither replaces the other. The NT scan screens for chromosomal risk in the first trimester; the anomaly scan checks structural development in the second trimester. Both are included in the Mother 9 antenatal package.
At Mother Hospitals, the anomaly scan is not an isolated appointment — it is the centrepiece of second-trimester care in the Mother 9 antenatal programme.
The Mother 9 Card gives you complete antenatal monitoring across all three trimesters for just ₹500. This includes the anomaly scan (TIFFA) at 18–22 weeks, the NT scan at 11–14 weeks, growth scans in the third trimester, all check-up consultations with Dr. Prashanthi, blood test review appointments, and personalised birth planning support. One doctor, one continuous relationship, from first scan to delivery.
This is not an insurance product — it is a structured maternity care package designed so that no critical scan or appointment is ever missed. Learn more about the full Mother 9 programme →
The value of an anomaly scan is not just in the scan itself — it is in what happens before and after it. If the NT scan at 11–14 weeks showed an elevated NT, that context informs how Dr. Prashanthi interprets any soft markers on the anomaly scan. If gestational diabetes was detected at 24 weeks, that changes what to look for on the growth scan at 32 weeks.
At Mother Hospitals, all these data points are tracked by the same doctor who knows your complete history. This integrated approach is what separates genuine specialist antenatal care from a series of isolated scan appointments.
The quality of an anomaly scan depends entirely on the expertise of the person performing it and the quality of the equipment used.
At many scan centres, the anomaly scan is performed by a sonography technician and only reported by a doctor who may not have performed the scan themselves. At Mother Hospitals, Dr. E. Prashanthi Reddy performs and interprets the scan personally — she sees what the probe sees, in real time, and applies clinical judgment to every finding. This makes a difference to the thoroughness and accuracy of the assessment.
The anomaly scan requires high-resolution ultrasound equipment to visualise fine structures such as the outflow tracts of the heart, the corpus callosum of the brain, and the detailed lip architecture for cleft screening. Mother Hospitals uses modern, high-resolution ultrasound machines calibrated for obstetric use — image quality that makes subtle findings visible, not missed.
Dr. Prashanthi's PG Diploma in ART from Kiel University, Germany, included extensive exposure to European obstetric ultrasound protocols. Her training reflects the structured, protocol-driven approach to anomaly scanning that is the standard in international fetal medicine centres — systematic, documented, and thorough.
The anomaly scan report is not handed to you through a receptionist. Dr. Prashanthi explains every finding — normal and abnormal — in plain language. You leave the appointment understanding what was seen, what it means, and what (if anything) happens next. This clarity is especially important if any finding has been made, however minor.
Your anomaly scan at Mother Hospitals is interpreted in the context of your complete antenatal history — your NT result, your first-trimester blood test results, your medical history, and your risk profile. This contextual knowledge is only possible when the same doctor manages your entire pregnancy from the start.
For just ₹500, the Mother 9 Card includes the anomaly scan along with all other antenatal appointments, scans, and blood test reviews across your entire pregnancy. You do not pay separately for each scan — your whole pregnancy is covered, and not one check-up is skipped.
MBBS · DGO · PG Diploma in ART — Kiel University, Germany
Founder & Medical Director — Mother Hospitals & IVF Center, Boduppal
TGMC Registration: 50624 · 20+ Years Experience · 10,000+ Families
Common questions about the anomaly scan — what it detects, timing, what to expect, and what happens if something is found.
No — the anomaly scan detects approximately 60–70% of major structural abnormalities when they are present. It does not detect all conditions. Some birth defects are not visible on ultrasound (chromosomal microdeletions, metabolic disorders, minor skin conditions), some are very subtle (small ventricular septal defects, minor palate clefts), and some only become apparent later in pregnancy (some cardiac conditions, brain migration anomalies). A normal anomaly scan is highly reassuring but is not a guarantee that the baby has no structural differences at all. It remains the most powerful non-invasive structural screening tool available in the second trimester.
The anomaly scan is not legally mandatory in India — it is a recommended standard of care, strongly advised by FOGSI (Federation of Obstetric and Gynaecological Societies of India) and ICMR (Indian Council of Medical Research) as part of routine antenatal care for all pregnant women. While you cannot be compelled to have it, declining the anomaly scan means that structural birth defects that might otherwise be detected in pregnancy would only be found at birth — which can limit the options for birth planning, specialist involvement at delivery, and postnatal care preparation. For the vast majority of women, the anomaly scan provides profound reassurance; for the minority where a finding is made, it enables timely preparation and informed decisions.
The anomaly scan is routinely performed at 18–22 weeks, when fetal genitalia are visible on ultrasound. However, in India, disclosure of the baby's sex is prohibited under the Pre-Conception and Pre-Natal Diagnostic Techniques (PC-PNDT) Act. This law applies to all ultrasound scans performed in India, without exception. No doctor, sonographer, or scan centre in India can legally disclose the baby's sex during a pregnancy scan. This is a criminal offence under Indian law, not a matter of clinic policy. Mother Hospitals strictly complies with the PC-PNDT Act, and sex determination will not be communicated at any scan.
Yes — partners and support persons are warmly welcome at the anomaly scan at Mother Hospitals. This is one of the most memorable and significant scans of your pregnancy — seeing the baby's face, hands, and heartbeat in detail at 20 weeks is an extraordinary experience. We recommend bringing your partner or a support person, especially for your first pregnancy. Please let us know when booking so we can ensure suitable space in the consultation room. Due to clinical reasons, we ask that only one additional person accompany you for the scan itself.
If the anomaly scan identifies a finding — whether a soft marker, a minor variant, or a structural abnormality — Dr. Prashanthi will explain it to you clearly and calmly at the end of the appointment. The vast majority of findings at the 20-week scan turn out to be benign or insignificant when investigated further. Depending on what is found, the next steps may include: a repeat scan in 2–4 weeks to reassess a borderline finding; referral to a Fetal Medicine specialist for a detailed expert scan; NIPT (if soft markers are found and chromosomal risk assessment is needed); echocardiography for cardiac findings; or genetics consultation. You will never be sent home with a finding and left without a clear plan. Dr. Prashanthi stays until all your questions are answered.
A comfortably full bladder is helpful for the anomaly scan but is less critical than for a first-trimester scan. By 18–22 weeks, the uterus is large enough to be easily seen abdominally without a full bladder. Drink 2–3 glasses of water about 30 minutes before your appointment. If your bladder becomes uncomfortably full before the scan, you can partially empty it — the scan will still be achievable. Unlike the NT scan, a transvaginal scan is rarely needed for the anomaly scan. Loose, comfortable clothing is more important than bladder preparation at this stage.
There is no difference — anomaly scan, morphology scan, TIFFA scan, anatomy scan, 20-week scan, and Level II scan all refer to the same detailed second-trimester ultrasound. Different hospitals and different regions of India use different terminology, but the scan content and purpose are the same: a systematic, structured assessment of all major fetal anatomical structures between 18 and 22 weeks of pregnancy. At Mother Hospitals, we may use any of these terms — they all refer to the same detailed examination.
No — the anomaly scan is completely painless. It uses standard abdominal ultrasound — gel is applied to the abdomen and a probe is moved gently across the skin. There are no needles, no internal instruments, and no radiation. The only mild discomfort some women experience is from having a full bladder, which is easily relieved if needed. The baby cannot feel the ultrasound waves. You may feel gentle pressure as the probe is angled to get different views — this is normal and not harmful. The scan is safe for both mother and baby and uses the same ultrasound technology used in all pregnancy scans for over 50 years.
Complete scan coverage from first trimester to delivery — all managed by the same doctor as part of the Mother 9 antenatal programme.
Dr. E. Prashanthi Reddy · Mother Hospitals, Boduppal · TGMC Reg: 50624