Your first ultrasound

“Your first ultrasound scan will be one of the most important milestones along your pregnancy journey,” says Dr Dalene Barnard, a gynaecologist and obstetrician at Mediclinic Kloof. “There is honestly no feeling that comes close to the excitement of hearing your baby’s heartbeat for the first time.” 

An ultrasound is a non-invasive procedure used to monitor the development of your baby, check for potential issues and provide reassurance that everything is progressing as expected, she explains.

The first ultrasound, called the dating scan, usually happens between six and nine weeks of pregnancy. Your will doctor will check if the pregnancy is in the uterus (to make sure it’s not ectopic, where the egg implants outside the uterus). They will also estimate how far along the pregnancy is, look for a heartbeat, see if there’s more than one baby, and check the overall health of the pregnancy.

Since your baby will be only the size of a blueberry or small bean, you won’t be able to see very much on the scan. But you’ll be able to make out the developing embryo, and you might even see the tiny flicker of a heartbeat.

For the clearest ultrasound image, keep your bladder full if the scan is done on your stomach. The doctor will put gel on your belly and move a handheld probe over the area. Drink a glass or two of water about an hour before your appointment and try not to use the bathroom until after the scan.

If you’re having an internal (transvaginal) scan, your bladder should be empty. In this case, a small probe is inserted into the vagina to get a clearer view of the baby and surrounding tissue. This might feel uncomfortable, but it’s usually not painful.

You’ll probably have a lot of questions for your doctor at this point. “Don’t hesitate to mention any concerns,” says Dr Barnard. “Remember, this scan is not only about gathering essential medical information. It’s also about making sure you feel supported and informed every step of the way.”

Here are some common questions you might want to ask during your ultrasound:

• Are there any signs of complications? This is a good time to check for any issues, like an ectopic pregnancy, a blighted ovum, or the risk of miscarriage.
• What is my due date? The doctor can measure the baby’s size to give you the most accurate due date.
• Am I having twins or more? They can check for multiple babies.
• When is my next ultrasound? This usually happens between 20 and 23 weeks, and the doctor can explain what to expect at this next ultrasound.

Generally, your doctor will want to see you once a month and your blood pressure and urine will be examined at each appointment.

Key scans and tests in pregnancy

Dating scan

When: 6-9 weeks
Purpose: Checks for a heartbeat and confirms that the pregnancy is in the uterus while also giving you a possible date of birth.

Nuchal translucency scan

“This is arguably the most important scan in your pregnancy.”
When: 11-13 weeks

Purposes:

1. Check that all the vital organs, like the brain, heart, and kidneys, have formed properly.
2. Look at the baby’s physical development, showing details like the arms, legs, and face.
3. Check for soft markers of Down syndrome, like neck thickness (nuchal translucency) and nasal bone visibility. These aren't problems on their own but can affect risk levels.

16-week scan

When: 16 weeks
Purpose: Confirms your baby’s gender.

Anatomy scan

When: 18-22 weeks.
Purpose: The doctor checks your baby from head to toe, looking at tiny details like the heart valves, toes, and even the face.

Remember that many medical aids provide cover for two scans only. “You and your doctor may wish to scan more frequently, so be sure to discuss this with your gynaecologist,” Dr Barnard says.