Anomaly Scan in Pokhara — 18–22 Week Level II Ultrasound

What is an anomaly scan?

An anomaly scan is a detailed mid-pregnancy ultrasound that checks your baby’s organs and body structures one by one, usually between 18 and 22 weeks. It is also called a Level II ultrasound, TIFFA scan (targeted imaging for fetal anomalies), anatomy scan or 20-week scan. If you are looking for an anomaly scan in Pokhara, Kaligandaki Diagnostic and Research Center (KDRC) at Shantipath, Amarsingh Chowk, performs it on a high-definition ultrasound system with 3D, 4D and volume scanning — and anomaly scans are available any day of the week.

The scan uses sound waves, not X-rays, so it is safe for you and your baby. It looks at the baby’s brain, face, spine, heart, chest, abdomen, kidneys, bladder, arms and legs. It also measures growth and checks the placenta, the amniotic fluid and, where relevant, the cervix. For most families the scan is reassuring. When a difference is found, finding it at this stage gives time for further tests, specialist advice and careful planning of the birth.

When should the anomaly scan be done? (Kati hapta ma garne?)

The anomaly scan is best done between 18 and 22 weeks of pregnancy, and many guidelines recommend the narrower window of 18 weeks 0 days to 20 weeks 6 days. The NHS describes the 20-week scan as usually done at 18 to 21 weeks, sometimes up to 23 weeks (NHS), and the English screening programme sets 18+0 to 20+6 weeks as the optimal window (GOV.UK).

Patients in Pokhara often ask “anomaly scan kati hapta ma garne?” — the short answer is around 20 weeks. Before 18 weeks, the baby’s heart, face and spine are smaller and harder to see in full detail. After about 22 weeks, the bones become denser and cast more shadows, and there is less time for follow-up tests if something needs checking. Your due date is calculated from the dating scan, so bring that report — it helps us book you in the right week. If you have not had an early scan, a routine pregnancy ultrasound can confirm your dates first.

If the baby lies in an awkward position, the sonographer may ask you to walk, change position or have a snack, and occasionally a short repeat visit is needed. The NHS notes that a repeat scan is offered when clear pictures cannot be obtained the first time.

What does the anomaly scan check? Organ-by-organ

The anomaly scan checks every major body system of the baby, together with the placenta and fluid that support the pregnancy. The radiologist works through a set checklist so that no area is missed.

The NHS 20-week scan specifically screens for 11 conditions: anencephaly, open spina bifida, cleft lip, diaphragmatic hernia, gastroschisis, exomphalos, serious cardiac abnormalities, bilateral renal agenesis, lethal skeletal dysplasia, Edwards’ syndrome (trisomy 18) and Patau’s syndrome (trisomy 13), according to the NHS. A full Level II scan at KDRC follows the same organ-by-organ approach, and the radiologist reports any other finding seen during the examination.

What can an anomaly scan detect — and what can’t it?

An anomaly scan detects most major structural conditions, but no ultrasound can find every problem. A large national study of the English fetal anomaly screening programme, covering pregnancies due from April 2017 to March 2020, measured how often the scan found specific conditions (BJOG 2023).

These figures come from a national programme in England and show what a careful scan can achieve; detection in any single pregnancy also depends on the baby’s position, the mother’s body build, the gestation and the condition itself. Some important limitations are worth knowing:

• Small heart defects, such as small holes between chambers, are often too small to see.
• Chromosomal conditions like Down’s syndrome may show no visible sign; the anomaly scan is not a test for them. Screening for Down’s syndrome is offered earlier, with the NT scan and blood test.
• Some conditions appear later in pregnancy or only after birth, including some bowel blockages and certain brain and kidney changes.
• Function cannot be measured — the scan shows structure, not hearing, vision or learning ability.

A normal anomaly scan is reassuring, but it does not guarantee a baby without any health condition. Keep going to your regular antenatal check-ups.

NT scan vs anomaly scan vs growth scan

The NT scan, anomaly scan and growth scan are three different pregnancy ultrasounds done at different weeks for different purposes. Most women have at least two key scans — one at 11–14 weeks and one at 18–21 weeks — according to the NHS.

The NT measurement is part of the combined screening test, which needs to be done between about 10 and 14 weeks (NHS). If you missed it, the anomaly scan is still important — it answers a different question. All three scans, and the routine pregnancy scans in between, are described on our main ultrasound (USG) in Pokhara page.

How to prepare for an anomaly scan

An anomaly scan needs very little preparation: you do not need to fast, and a full bladder is usually not required at this stage of pregnancy. A few simple steps help the scan go smoothly.

Some women find that eating a light snack beforehand makes the baby more active, which can help when the baby is lying in a difficult position. Moisturisers and oils on the tummy can affect the image, so it is best to skip them on the day of the scan.

What happens during the anomaly scan at KDRC?

During the anomaly scan you lie on a couch while the sonographer moves a gel-covered probe over your tummy and works through each part of the baby in turn. The NHS notes that the scan usually takes around 30 minutes, and longer if the baby is moving a lot or not in a good position.

The room is dimmed so the screen is easy to see, and your partner or a family member can sit with you. The radiologist may go quiet while concentrating on the heart — this is normal and does not mean something is wrong. You will be told about the main findings, and you are welcome to ask questions.

3D and 4D views with your anomaly scan

KDRC can add 3D and 4D views to the anomaly scan, giving you a lifelike picture of your baby’s face and movements alongside the standard medical examination. The medical part of the anomaly scan is done in 2D, which gives the most accurate measurements and views of internal organs. 3D can help the radiologist look at the face, lips and limbs from extra angles, and 4D shows the baby moving in real time.

The US FDA discourages ultrasound performed only to make keepsake videos, but accepts keepsake images captured during a medically indicated scan when no extra exposure is added. That is why at KDRC 3D/4D images are taken as part of a clinically requested scan, not as a separate entertainment session.

Anomaly scan in twin pregnancies

In a twin pregnancy, each baby receives its own full anomaly check, so the scan takes longer and needs more patience from everyone. The radiologist identifies each twin by position, examines every organ for both babies, and checks each baby’s growth, fluid and placenta. Whether the twins share a placenta is ideally confirmed at the first-trimester scan, because twins sharing a placenta need closer monitoring.

Growth checks are particularly important when you are carrying twins, as the NHS points out, and your obstetrician will usually plan more frequent scans after the anomaly scan. Please tell us when booking that you are expecting twins so we can allow enough time. If blood-flow studies are needed later, see our colour Doppler page.

Is ultrasound safe in pregnancy?

Yes — ultrasound uses sound waves rather than radiation, and the NHS states there are no known risks to the baby or the mother from a pregnancy scan. Diagnostic ultrasound can slightly warm tissue, so the FDA recommends that operators follow the ALARA principle — “as low as reasonably achievable” — using the least energy and time needed for a diagnostic image.

Our radiologists apply ALARA to every pregnancy scan: they use appropriate settings, keep Doppler use to what is clinically needed, and do not prolong scanning without a medical reason. The anomaly scan is a medically recommended test, and its benefits are well established.

When to seek urgent care: the anomaly scan is a planned, routine test. Do not wait for your appointment if you have heavy vaginal bleeding, severe or persistent tummy pain, leaking fluid, a severe headache with blurred vision or swelling, fever, or if you notice your baby moving much less than usual later in pregnancy. Go to your nearest maternity emergency department straight away. If you need transport in Pokhara, our ambulance service can help — call 061-553538 or 9856077433.

Can the anomaly scan tell the baby’s sex?

No — KDRC does not determine or disclose the sex of the baby during an anomaly scan or any other pregnancy scan. In Nepal, Section 188 of the Muluki Criminal Code (National Penal Code), 2074 prohibits identifying the sex of a foetus with the intention of causing an abortion and prohibits sex-selective abortion, with prison sentences for those involved (Section 188, National Penal Code 2074).

In line with this law and our professional responsibility, our staff and radiologists will not tell you whether your baby is a boy or a girl, and please do not ask them to. The purpose of the anomaly scan is to check your baby’s health. Every baby deserves the same care.

Under Section 188 of Nepal's Muluki Criminal Code (National Penal Code) 2074, identifying fetal sex with the intention of abortion and sex-selective abortion are criminal offences. KDRC does not determine or disclose fetal sex on any pregnancy scan.

What happens if something is found on the anomaly scan?

If the scan shows a possible problem, the radiologist explains what was seen and writes a detailed report so your obstetrician can arrange the next steps quickly. Many findings are minor or resolve on their own; others need further assessment.

Depending on the finding, your doctor may suggest a repeat or follow-up scan, a referral to a fetal medicine specialist, or diagnostic tests such as amniocentesis or chorionic villus sampling, which can confirm whether the baby has a condition (NHS). Detailed counselling helps you understand the outlook, treatment after birth, and where the safest place to deliver would be. Some conditions are best managed by delivering at a hospital with a neonatal intensive care unit or paediatric surgical team.

In the English screening programme, women with a suspected finding should be seen by a specialist within a few working days (GOV.UK), which shows how important prompt follow-up is. Take your KDRC report to your obstetrician without delay. Our radiologists are happy to speak with your doctor, and images can be shared with referring hospitals through our teleradiology service.

How much does an anomaly scan cost in Pokhara?

The cost of an anomaly scan in Pokhara depends on what the examination includes, so KDRC quotes the price individually instead of listing a fixed rate. Factors that affect the price include whether 3D/4D views are added, whether you are carrying twins, and whether Doppler studies are requested by your doctor. Prices are reviewed from time to time. For the current anomaly scan price in Pokhara, call 061-553538 or 9856077433 (Viber); our staff will also tell you the best week to book.

Why choose KDRC for an anomaly scan in Pokhara?

Families choose KDRC for their anomaly scan in Pokhara because it combines a high-definition 3D/4D ultrasound system, experienced consultant radiologists and availability any day of the week.

• Available any day of the week: anomaly scans and other services can be booked any day, so you can choose a date that fits your 18–22 week window and your family’s schedule.
• HD ultrasound with 3D, 4D and volume scanning, plus colour Doppler when your doctor requests it.
• Consultant radiologists: Dr. Bishworaj Bastakoti and Dr. Nawaraj Paudel have been consultant radiologists at KDRC since its inception, are members of the Nepal Radiologist Society, and have been NMC-registered radiologists since 2016. Read more on our doctors page.
• One centre for the whole pregnancy: dating and NT scans, the anomaly scan, growth scans and mobile ultrasound for women who cannot travel.
• Ethical practice: we follow Nepal’s law and do not disclose fetal sex.

KDRC is located at Shantipath, Amarsingh Chowk, Pokhara-10, Kaski. If you searched “anomaly scan near me” from Lakeside, Bagar, Lekhnath or anywhere in Pokhara, call 061-553538 or 9856077433 or use our online appointment form to book. Visit our contact page for directions, or see all KDRC services.