What Happens During First Trimester Ultrasound?

Your first-trimester ultrasound offers the first glimpse of your fetus. It can help your doctor confirm your pregnancy, check if you’re having twins, figure out your due date, and more.

A first-trimester ultrasound is one that occurs from the fifth week up to and including the 13th week of pregnancy. The test is painless and safe, both for you and your baby.

Unlike ultrasounds in the second trimester, first-trimester ultrasounds don’t show detailed images of the organs. Therefore, the ultrasound cannot determine the baby’s sex or rule out most fetal abnormalities.

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What Does a First-Trimester Ultrasound Show?

If your doctor doesn’t have any concerns about your pregnancy, you may not need a first-trimester ultrasound. However, many parents prefer a first-trimester ultrasound even if there are no concerns.

The first-trimester ultrasound gives information on the pregnancy at an early date, which can be helpful for planning things like parental leave. How much you learn from a first-trimester ultrasound depends on when you have it.

First-trimester ultrasound: 5 to 11 weeks

Ultrasounds in this time confirm the pregnancy, the number of fetuses, and help doctors estimate the due date. By six weeks, your ultrasound technician is usually able to detect a heartbeat as well. But ultrasounds at this early stage will usually not detect fetal abnormalities, unless they are very severe.

Five weeks (about a week after a missed period) is the earliest time to visualize a fetus. Your doctor may suggest a first pregnancy ultrasound at 5 weeks to rule out ectopic pregnancy. This is a rare condition where the fetus has attached outside of the uterus, and it requires immediate medical treatment.

Your doctor may also suggest an early ultrasound if there are signs of early miscarriage. Cramping and spotting or bleeding in early pregnancy can be signs of both miscarriage and ectopic pregnancy.

Even if all is going well, you might opt for an ultrasound this early for peace of mind. You might also want to find out early if you’re carrying one, or more!

First-trimester ultrasound: 12 to 13 weeks

Doctors do ultrasounds at this time to estimate the due date by measuring the fetus. They can also listen to the heart rate.

Your ultrasound technician may also perform a nuchal translucency test at this time. This test is optional. In this test, the technician measures the thickness between the spine and the skin of the fetus’s neck.

A build-up of fluid here can be a sign of Down syndrome as well as other rare conditions. The test only indicates a high or low risk of certain genetic problems and is not 100% conclusive. If the test shows a high risk, the doctor will suggest more tests to confirm or rule out any problems.

What Happens in Your First-Trimester Ultrasound?

Your first-trimester ultrasound typically takes around five to 20 minutes, depending on the purpose. (A test to confirm the pregnancy will usually be on the short end while a nuchal translucency test will be longer.)

Both a transvaginal ultrasound and transabdominal ultrasound use the same technology. The ultrasound wand emits sound waves that bounce off your internal organs as well as your fetus’s tissues and bones. The computer then generates an image based on the sound wave echoes.

Transvaginal ultrasound

If you have your first pregnancy ultrasound at 5 weeks or 6 weeks, you may need to have a transvaginal ultrasound. This is because the fetus is too small to visualize with an abdominal ultrasound.

Rather than placing the ultrasound wand on your belly, the technician will insert the ultrasound wand in the vagina. You will lie on the examining table with your feet in stirrups. While the insertion of the wand may cause some discomfort, it should not be painful. It is acceptable to ask your ultrasound technician if you can insert the wand yourself for comfort.

Transabdominal ultrasound

Beyond the sixth week, you will likely get a transabdominal ultrasound. For this ultrasound, your health provider may ask you to drink water and avoid urinating close to the test.

This is because the technician may be able to better view the fetus if the bladder is at least partly full. However, it is not necessary to keep a full bladder to the point of discomfort.

For this ultrasound, you will lie in a reclining position on the examining table. The technician will apply a cool gel to your belly. Then, the technician will move the wand around the surface of your skin.

The technician may at times press the wand into the skin to send the sound waves to the right location. While this may feel slightly uncomfortable, this should not feel painful. If you feel pain, let the technician know so they can reduce the pressure.

After your ultrasound

After your technician completes the ultrasound, you may need to see your doctor to discuss the results. Your doctor may not need to speak to you on the day of the ultrasound if all is well.

Most ultrasound clinics will provide you with images from your scan, so be sure to ask for these black-and-white pictures. Many parents find this image helps them to connect with their future baby and makes the pregnancy feel real.

American College of Obstetricians and Gynecologists. Ultrasound exams. Link

American College of Obstetricians and Gynecologists. Prenatal genetic screening tests. Link

Colleen de Bellefonds. Ultrasound during pregnancy. What To Expect. Link

Anna Nowogrodski. When and why to get ultrasounds during pregnancy. New York Times. Link

Tricia O'Brien. Pregnancy ultrasounds week by week. Parents. Link

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.