First ultrasound pregnancy: Understanding the early timeline of your pregnancy screenings

The first ultrasound during pregnancy has huge medical significance. During it, your healthcare provider will check pregnancy viability, detect the number of fetuses, and estimate your due date. At the same time, this screening also has a huge significance for you, providing the so-needed reassurance and supporting psychological adaptation to pregnancy.

The typical time for the first ultrasound pregnancy is between 6 and 9 weeks of gestation. However, it’s also possible to have your ultrasound earlier (at 5 weeks) or later (at 12 weeks). The exact timing depends on your unique situation, as well as your doctor’s practice.

The first-trimester sonogram is typically done transvaginally, which is completely safe. However, it’s important to set realistic expectations for what you will see because your baby might still be very small.

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When you embark on your trying-to-conceive journey, there are quite many unknowns that you might want to wrap your head around so that you know what’s to come. When you’ve got past all the previous important milestones, such as tracking your ovulation, conceiving, and finally getting a big fat positive around 18 DPO, the next big event awaiting you is your first-ever ultrasound. And chances are that you want to know everything about it in advance.

In this article, we’ll delve into the specs of the first ultrasound pregnancy. We are going to discuss the earliest time when it’s possible to have one, the typical screening schedule, the procedure itself, and other big questions that you might have. Let’s dive in!

What Is a Pregnancy Ultrasound and Why Does It Matter?

An ultrasound is an imaging examination that uses sound waves to produce an image of your internal organs. In pregnancy, it’s done to gain an image of your fetus and use it to evaluate how your pregnancy progresses. This form of screening is essential in pregnancy because it allows for the detection of the due date and any possible complications early, which is crucial for ensuring maternal and fetal health.

Traditionally, there are two essential pregnancy ultrasounds. The first one is done in the first trimester, and the second one in the second trimester of pregnancy. However, this is not a rule. Depending on your healthcare provider’s practice and your unique situation, it’s possible to have more ultrasounds at different stages of your journey.

What Is the First Ultrasound in Pregnancy?

As was already mentioned, the first ultrasound in pregnancy is done in the first trimester. And it’s one of the most important milestones in early pregnancy.

It’s commonly known as a “dating and viability” screening. It performs a number of pivotal functions:

• Viability confirmation: During the first ultrasound, a healthcare provider will locate the embryo in the uterus and check its main structures to confirm that pregnancy is progressing. The doctor will also rule out ectopic pregnancy and other complications.
• Fetus(es) detection: During the early screening, the doctor should be able to detect the number of fetuses located in the uterus and thus confirm or rule out multiple pregnancy. However, the accuracy of this depends a lot on your baby’s position and the time when you have your first ultrasound. According to studies, around 11% of twin gestations and 86% of monochorionic twin gestations were initially undercounted as singletons during the first sonogram.
• Due date estimation: Finally, the first ultrasound pregnancy is crucial for measuring your baby’s size and detecting the expected due date early on. This is an important step for preparing an effective personalized care plan for a healthy pregnancy journey.

Apart from medical significance, first pregnancy sonograms also hold enormous significance for mothers-to-be. When done in the first trimester, an ultrasound provides reassurance that the pregnancy progresses as expected. This helps eliminate anxiety and improve your psychosocial adaptation to pregnancy.

When Is First Ultrasound in Pregnancy?

The general timeframe to have the first ultrasound during pregnancy is between 6 and 9 weeks of gestation. Often, healthcare providers prefer to do it later in this timeframe, for example, at 8 weeks or 9 weeks. By this time, the fetus is already somewhat grown, which makes it easier to receive a clear image, locate the major structures, and check the heartbeat. However, this is also not a strict rule.

The truth is that every pregnancy is unique. And so is every doctor’s practice. Sometimes, healthcare providers prefer to wait until at least 12 weeks to do the first sonogram. This gives your fetus more time to grow and develop, which allows for a more accurate pregnancy assessment. A longer wait until the first ultrasound is very common in uncomplicated pregnancies. So it shouldn’t be a cause of concern if your doctor tells you to wait.

On the other hand, it’s also possible to have your first-trimester sonogram earlier. The earliest time for the first ultrasound during pregnancy is 5 weeks. Although it’s considered slightly early (as the baby is still very small), you may be referred to an earlier screening for a number of reasons:

• You reported any adverse symptoms, such as bleeding or pain.
• There is a suspicion of ectopic pregnancy.
• There is a suspicion of multiple pregnancy.
• You have a high-risk pregnancy based on your medical or obstetric history, or if you are going through IVF or assisted reproductive technology.

First Ultrasound Pregnancy: The Process and What to Expect

As you get prepared for your first ultrasound, you must be wondering how it will go and what you will be able to see. At this stage, we have to emphasize the importance of setting realistic expectations. The thing is that your first sonogram is typically done quite early in pregnancy, when the baby is still very small and not fully developed. That is, the process and image might be different from what you expect. And it can cause additional stress. To help you prevent stress and disappointment, let’s delve into the specs of the first ultrasound pregnancy.

Firstly, how is it done? Is the first pregnancy ultrasound internal or external? This, in fact, is one of the most common misconceptions mothers-to-be have, especially if it’s their first child. We bet that you’ve all seen how an external (abdominal) ultrasound is done on TV. However, you need to prepare for your first sonogram to be transvaginal. This is because your baby is still small in the first trimester, and an abdominal ultrasound may not provide a clear and detailed image. But don’t worry, this procedure is absolutely safe for you and your baby.

Now, what can you see during the screening? The answer to this question varies depending on the specific time when you have your sonogram. If it’s done early, for example, at 5-6 weeks, you shouldn’t expect to see your baby clearly. Since the fetus is still small, you will only be able to see the gestational sac, yolk sac, and fetal pole. However, if you have your first ultrasound later in pregnancy, you might be able to see more because your baby grows and develops every week. For example, at 12 weeks, you should already see your baby’s head, body, and limbs.

FAQ

Why is the first pregnancy ultrasound internal?

The first ultrasound pregnancy is done transvaginally because it allows the probe to be closer to the uterus. Since the fetus is still very small in the first trimester, an internal screening allows doctors to receive a much more detailed and clear image of the baby. This helps identify its main structures and check for possible complications with more precision.

Will first ultrasound show ectopic pregnancy?

Yes, it should. According to experts, first-trimester sonograms detect over 70% of ectopic pregnancies. Thus, there is a good chance that you will receive a definitive diagnosis from your doctor. However, it’s also possible that the healthcare provider is unable to identify the fetus inside or outside the uterine cavity. In this case, it's not a definitive answer, and additional screenings will be required to follow up.

How do I prepare for my first ultrasound during pregnancy?

Generally, there is no special preparation needed for this procedure. However, a few things you may want to do are to choose comfy clothes and empty your bladder before screening because a transvaginal ultrasound can add pressure on it. If you have any further concerns about preparation and about the procedure itself, don’t hesitate to ask your healthcare provider.

Conclusion

Preparing for your very first ultrasound pregnancy is both stressful and exciting. On the one hand, you will finally be able to confirm your pregnancy and gain the so-needed reassurance. However, on the other hand, this procedure might be new to you, and the unknown can add stress.

Luckily, after reading this guide, you should have a clear idea of when and how this process goes. Use this knowledge to prepare for this important moment in your journey, and don’t forget to set realistic expectations to avoid unnecessary stress.

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