Fetal Echo vs Anomaly Scan: What's the Difference?

Both the anomaly scan and the fetal echocardiogram are ultrasound scans done in the second trimester. The anomaly scan, also called the TIFFA or 20-week scan, checks the whole baby. The fetal echo is a specialised scan that focuses only on the baby's heart in much greater detail.

What does the anomaly scan check?

The anomaly scan reviews the brain, face, spine, heart, chest, abdomen, kidneys, bladder, limbs, placenta, amniotic fluid and growth. For the heart, it typically includes the four-chamber view and views of the major outflow vessels.

What does a fetal echo check?

A fetal echo looks closely at:

• All four heart chambers and their size
• Heart valves and how they open and close
• The major arteries and their connections
• The walls between chambers, looking for holes
• Blood flow using colour Doppler
• Heart rhythm and rate

It takes longer and is usually performed by a fetal medicine specialist or fetal cardiologist.

How do they compare?

| Feature | Anomaly scan | Fetal echo |

|---|---|---|

| Focus | Whole baby | Heart only |

| Timing | About 18 to 22 weeks | About 18 to 24 weeks |

| Heart detail | Standard screening views | Comprehensive assessment |

| Who needs it | All pregnant women | Higher-risk pregnancies or concerns |

| Duration | Moderate | Longer |

Can the anomaly scan detect heart defects?

It detects many major heart defects, but some, particularly those affecting valves, small holes or vessel connections, can be missed. Detection depends on fetal position, maternal body type, gestational age and operator expertise. A fetal echo improves detection in higher-risk pregnancies.

When do you need both?

You may need a fetal echo in addition to the anomaly scan if:

• The anomaly scan shows or suspects a heart concern
• NT was increased in the first trimester
• There is a family history of heart defects
• You have diabetes or certain medical conditions
• The pregnancy is through IVF
• There are monochorionic twins
• The baby's heart rhythm is abnormal

Keeping it simple

The anomaly scan and fetal echo complement each other. Knowing when you need each helps ensure your baby's heart is checked thoroughly. Dr Malathi G. Prasad performs anomaly scans and fetal echocardiography in Trichy.

You can read about how we run the fetal echo at our centre, and who performs it, on the team page.

Related guides

• What Is a Fetal Echo and When Is It Done?