Frequently Asked Questions
The Pregnancy Clinic provides comprehensive, consultant-led care for women and families before, during, and after pregnancy. The Pregnancy Clinic provides planned, scheduled appointments only and does not offer urgent or emergency care. Any urgent concerns should be directed to your local NHS maternity unit or emergency services.
- Private antenatal care, offering personalised, consultant-led pregnancy care with continuity, clear planning, and expert oversight throughout pregnancy.
- Pregnancy consultations, tailored to your individual needs at different stages, including:
- Pre-conception consultations
- Antenatal consultations
- Postnatal consultations
- Pregnancy ultrasound scans, including a full range of scans from early reassurance and viability through to detailed growth and wellbeing scans in the third trimester.
- Pregnancy-related investigations, including non-invasive prenatal testing (NIPT), blood tests, and urine and vaginal swabs, where clinically appropriate.
We offer a comprehensive range of pregnancy ultrasound scans from early pregnancy through to the third trimester, including:
- Early reassurance and viability scans
- Nuchal scans (11–13 weeks)
- Detailed fetal anomaly scans
- Specialist fetal heart (cardiac) scans
- Cervical length assessment
- Growth and Doppler scans to monitor fetal wellbeing in later pregnancy
- 3D and 4D scans for reassurance and bonding
All scans are tailored to your stage of pregnancy, clinical circumstances, and individual needs, and are delivered within a consultant-led care pathway to ensure accurate assessment and clear, reassuring guidance.
All ultrasound scans at The Pregnancy Clinic are performed by Consultant Fetal Medicine specialists or highly experienced clinicians working within consultant-led pathways. This ensures high diagnostic accuracy and clear explanations at every appointment.
No referral is required. You can Book Your Appointment directly with us. If you have had previous scans or care elsewhere, you are welcome to bring those reports to your appointment.
At The Pregnancy Clinic, we believe pregnancy care should never feel rushed. Our ultrasound appointments are carefully scheduled to allow plenty of time for a detailed scan, clear and reassuring explanations, and a relaxed consultation where all your questions are welcome. Most appointments last around one hour, although this may vary depending on the type of scan. Our priority is to ensure you leave feeling informed, supported, and confident about your pregnancy care.
Yes. We welcome partners and a close support person to attend your scan, as we understand this is an important and reassuring part of your pregnancy care. As each appointment is also a medical consultation, we kindly ask that attendance is limited to one or two supporting family members or friends to ensure a calm and focused environment. If you wish for additional people to attend, please discuss this with our team in advance of your appointment.
Yes. Ultrasound scans are widely used in pregnancy and are considered very safe for both mother and baby. Ultrasound uses sound waves, not radiation, to create images, and there is no evidence to suggest that ultrasound scans cause harm or adverse outcomes in pregnancy—even when scans are performed frequently.
At The Pregnancy Clinic, all ultrasound machines are specifically customised for use in pregnancy. They include built-in safeguards that carefully monitor thermal and mechanical indices, ensuring energy levels remain well within internationally accepted safety limits at all times. Scans are performed by highly trained specialists who use ultrasound responsibly and appropriately, focusing on obtaining the necessary clinical information while prioritising safety.
Ultrasound has been used in pregnancy for many decades and remains a cornerstone of modern antenatal care. You can feel confident that your scan is both safe and beneficial.
Yes. Colour Doppler ultrasound is safe when used appropriately by experienced professionals. It allows us to assess blood flow in the placenta, umbilical cord, and fetal vessels, providing important information about your baby’s wellbeing.
At The Pregnancy Clinic, Doppler is used selectively and thoughtfully, only when clinically helpful, and always within strict safety parameters. The same safety limits for thermal and mechanical indices apply, ensuring the scan remains well within safe levels.
Yes. The duration of a scan does not make it unsafe. Some detailed scans, such as fetal anomaly scans or detailed heart assessments, may take longer to ensure a thorough and accurate evaluation. Throughout the scan, ultrasound settings are continuously monitored and adjusted to remain within safe limits. Longer scan times reflect careful, detailed assessment—not increased risk.
Yes. There is no evidence that having multiple ultrasound scans during pregnancy causes harm to you or your baby. Many women have several scans as part of routine care or for reassurance and monitoring, particularly in higher-risk pregnancies. Repeated scans are commonly used worldwide to monitor growth, wellbeing, and placental function, and are considered safe when performed by trained professionals.
Yes. Having scans close together is safe. There is no minimum time interval required between ultrasound scans. If another scan is clinically indicated or would provide reassurance, it can be safely performed—even if you have had a scan recently. At The Pregnancy Clinic, each scan is carefully justified, focused, and tailored to your needs, ensuring both safety and value from every appointment.
If an unexpected is identified during your scan, it will be explained clearly, sensitively, and compassionately. Our priority is to ensure you fully understand what has been seen and what it may mean for your pregnancy. You will be supported by our Consultant who will:
- Explain the findings in a calm and understandable way
- Discuss whether further assessment or follow-up is needed
- Outline next steps and available options
- Liaise with your NHS fetal medicine or maternity team if appropriate
You will never be rushed or left without clear guidance. Our aim is to provide reassurance wherever possible and expert support whenever concerns arise.
The early pregnancy scan is performed to confirm that the pregnancy is located within the uterus and to assess early development. It allows confirmation of viability where appropriate, identification of the number of babies, and assessment of early pregnancy structures. This scan provides reassurance in early pregnancy and helps guide ongoing care.
An early pregnancy scan may be considered by anyone seeking reassurance following a positive pregnancy test. It is particularly helpful for women who have experienced bleeding or pain, have had a previous miscarriage or ectopic pregnancy, have conceived following fertility treatment, or are uncertain about their pregnancy dates.
The most appropriate time to book an early pregnancy scan depends on how far along the pregnancy is and what information you are hoping to obtain.
- At 5–6 weeks of pregnancy, the scan may show a small gestational sac within the uterus and, in many cases, a yolk sac. At this stage, it is often too early to reliably see a fetal heartbeat, and this can be entirely normal.
- From around 6½–7 weeks onwards, a fetal pole is usually visible and a heartbeat can typically be detected.
- Between 7 and 10 weeks, the scan provides more definitive reassurance. A heartbeat should be clearly seen, early development can be assessed, and the number of babies can be confirmed.
For most women seeking reassurance and a clear outcome from a single visit, booking the scan from 7 weeks of pregnancy onwards is ideal. If the scan is performed earlier, a follow-up scan may sometimes be recommended.
If your dates are uncertain or your cycles are irregular, this is taken into account when interpreting the scan findings. In early pregnancy, development does not always match the date of the last menstrual period, and this can be entirely normal.
If the pregnancy appears earlier than expected, this does not necessarily indicate a problem. Where appropriate, a follow-up scan may be recommended after a suitable interval to allow clearer assessment and provide reassurance.
The scan is usually performed initially through the abdomen. In very early pregnancy, or if views are limited, an internal (transvaginal) scan may be recommended to obtain clearer images. This is a safe and commonly used technique and will only be performed with your understanding and consent.
In some pregnancies after 7-8 weeks’ gestation, a scan through the tummy (abdominal wall) may be sufficient to confirm all the necessary findings in the early pregnancy. If the views through the tummy are limited and do not provide adequate visualisation of structures, either due to a different position of the womb or if the pregnancy is too early, then an internal (transvaginal) scan would be required as it often provides the clearest and most accurate images. This is very common, safe, and usually well tolerated.
A moderately full bladder can help improve visualisation during the abdominal part of the scan. You do not need to be uncomfortably full, and you may be asked to empty your bladder during the appointment if required.
Your scan will be performed in a calm, private, and supportive environment. Our consultant will carefully assess the pregnancy, explain what is seen on the ultrasound screen, and answer any questions you may have. You will never feel rushed, and reassurance is provided throughout the appointment.
You can expect clear information about:
- Whether the pregnancy is developing in the uterus
- Whether a heartbeat is seen
- The estimated gestational age and due date
- Whether there is one baby or a multiple pregnancy
- Any findings that may need follow-up or further assessment
All findings are explained in clear, reassuring language.
If a heartbeat is not seen, the findings are interpreted carefully in the context of how far along the pregnancy is and the scan appearances.
- Very early in pregnancy (before 7 weeks), it is common not to see a heartbeat, and this does not necessarily indicate a problem.
- If the pregnancy appears earlier than expected, or the findings are inconclusive, a repeat scan is usually recommended after 7–14 days to allow time for further development.
- If the scan findings meet established medical criteria for a non-viable pregnancy, this will be discussed with you sensitively and clearly.
Throughout this process, you will be fully supported, with clear explanations of the findings, what they mean, and the next steps. Where appropriate, we will also advise on follow-up care and liaise with NHS early pregnancy services to ensure continuity and safety.
Assessment of the risk of chromosomal conditions is not performed at the early pregnancy scan. This is undertaken later in pregnancy at the 11–13 week nuchal scan. Where appropriate, non-invasive prenatal testing (NIPT) can be offered from 10 weeks of pregnancy onwards.
Yes. If you are at least 10 weeks pregnant, NIPT can be performed at the same appointment. Testing earlier than this may increase the likelihood of an inconclusive result. Testing for fetal sex may be possible earlier.
Light bleeding or spotting can be common in early pregnancy and does not always mean there is a problem. However, bleeding can understandably cause anxiety. An early pregnancy scan can help clarify what is happening and provide reassurance or guide further care if needed. However, if you have ongoing bleeding, heavy bleeding, pain, or feel unwell, you should have an urgent assessment via your local NHS maternity unit or emergency services is recommended.
Yes. Twin or multiple pregnancies can usually be identified at an early pregnancy scan. If more than one baby is seen, this will be explained carefully, including information about the type of twin pregnancy and what this means for ongoing care.
The nuchal scan is a comprehensive early assessment of baby’s development:
- Confirm the number of babies (singleton or multiple pregnancy)
- Provide accurate dating of the pregnancy and estimate the due date
- Assess the baby’s early development and wellbeing
- Screen for common genetic conditions (Trisomy 21, 18 and 13)
- Identify or confidently exclude major birth defects detectable at this stage
- Undertake combined screening for preeclampsia and fetal growth restriction
This scan forms a key part of a holistic early pregnancy assessment
The most accurate way to determine the expected due date depends on how the pregnancy was conceived.
For naturally conceived pregnancies, the pregnancy dating should be based on ultrasound measurement of the baby’s crown–rump length (CRL) at the Nuchal scan. This is more reliable than using the date of the last menstrual period, as ovulation and cycle length can vary between individuals.
For pregnancies conceived through in vitro fertilisation (IVF) or other assisted reproductive techniques, the precise timing of conception is known. In these cases, the pregnancy is dated based on the known date of embryo transfer or fertilisation, rather than ultrasound measurements as it provides a more accurate dating.
This approach helps ensure that pregnancy dating is as accurate as possible, which is important for planning screening tests, monitoring fetal growth, and determining the timing of delivery if needed.
In most cases, the estimated due date (EDD) should not change once pregnancy dating has been established early in pregnancy, either from baby’s crown-rump length (CRL) in naturally conceived pregnancies or based on date of fertilisation or embryo transfer in IVF pregnancies.
Once established, the EDD should remain fixed for the rest of the pregnancy. All subsequent scans assess the baby’s growth relative to this original gestational age. Recalculating the estimated due date (EDD) based on measurements from later scans is generally not recommended as differences in size later in pregnancy usually reflect variation in fetal growth rather than inaccurate dating. Altering the EDD can make growth assessment unreliable and may lead to inaccurate interpretation of the baby’s development and wellbeing. An exception may be considered only if there are clear concerns that the original dating scan was technically suboptimal or performed outside the recommended early gestational age window.
For this reason, pregnancy dating should be kept consistent throughout the pregnancy, allowing later scans to focus on monitoring the baby’s growth and health accurately.
Combined screening is a personalised risk assessment for common genetic conditions such as Downs syndrome (Trisomy 21). It uses information from:
- Maternal factors, including age
- Ultrasound findings, specifically:
- Crown–rump length (the baby’s length from head to bottom)
- Nuchal translucency (the fluid space behind the baby’s neck)
- Blood tests, measuring two placental proteins:
- Free β-hCG
- PAPP-A
These factors are combined to calculate a personalised chance of the baby being affected by Trisomy 21, Trisomy 18 or Trisomy 13.
Combined screening is a well-established and effective screening test:
- Detection rate: approximately 85–90%, depending on operator expertise
- False-positive rate: around 2–3% (normal pregnancies classified as higher risk)
- False-negative rate: approximately 10–15%, (affected pregnancies classified as low risk)
It is important to note that combined screening is a screening test, not a diagnostic test, and results should always be interpreted in context and discussed with a specialist.
Early anatomy assessment refers to the systematic evaluation of the baby’s developing structures during the 11–13 week scan, often performed at the same time as the nuchal translucency assessment. Although the baby is still very small at this stage, modern high-resolution ultrasound allows experienced specialists to assess many key anatomical structures, including the brain, skull, spine, abdominal wall, stomach, bladder, limbs and early heart structure.
This early review is important because some structural conditions can already be detected in the first trimester, allowing earlier reassurance for most pregnancies and earlier identification of potential concerns when present. When findings are identified early, it allows appropriate counselling, further specialist assessment, and planning of care during the pregnancy.
It is important to note that the baby continues to develop throughout pregnancy, and therefore the detailed mid-pregnancy anomaly scan at around 20 weeks remains essential. The early anatomy assessment complements this later scan by providing an additional opportunity to evaluate development earlier in pregnancy.
Although this scan is performed early in pregnancy, many major fetal structures have already formed. At this stage, it is possible to assess and, in most cases, rule out serious abnormalities involving:
- The skull and brain
- The spine (including open spina bifida)
- The heart (major structural heart defects)
- The abdominal wall
- The limbs
While not all conditions can be excluded at this stage, the nuchal scan provides valuable early reassurance and identifies pregnancies that may benefit from further specialist assessment.
Yes. Effective combined screening for pre-eclampsia can be performed during the nuchal scan visit. This assessment uses:
- Maternal medical and obstetric history
- Blood pressure measurements
- Ultrasound Doppler assessment of placental blood flow
- Maternal blood tests (PAPP-A)
This approach can accurately identify women at increased risk of developing preeclampsia. There is strong evidence that women identified as high risk can benefit from early initiation of low-dose aspirin, which may reduce the risk or delay the onset of the condition.
Yes. Non-invasive prenatal testing (NIPT) is a highly accurate screening test for the common genetic conditions; it does not assess:
- The baby’s overall anatomical development
- Major structural birth differences
- Placental development or function
- The risk of pregnancy complications such as preeclampsia or fetal growth restriction
Many of these conditions can have similar implications for the health and wellbeing of the baby, even though their causes are different. The overall aim of a holistic assessment is to identify pregnancies at risk of complications early in pregnancy so that appropriate reassurance, monitoring and care can be provided.
The NIPT is for accurate assessment of genetic risk whereas the nuchal scan at 11–13 weeks provides a comprehensive early evaluation of the baby and the placenta including early indicators of structural abnormalities and placental-related conditions. These two tests assess different and complementary aspects of pregnancy health and are both equally important.
In most pregnancies, the nuchal scan is performed transabdominally (through the abdomen), and a full bladder is not required. Occasionally, if clear views cannot be obtained, a transvaginal (internal) scan may be recommended to ensure accurate assessment. This will always be discussed with you beforehand.
The advanced anomaly scan is a detailed assessment of both the baby and the placenta. Its key objectives include:
- Assessment of the baby’s growth and wellbeing
- A detailed examination of fetal anatomy
- Evaluation of ultrasound markers associated with genetic conditions
- Measurement of amniotic fluid volume
- Assessment of placental location and its relationship to the cervix (neck of the womb)
- In women with a previous caesarean section, assessment of the placenta-scar relationship to exclude abnormal placental attachment
- Evaluation of umbilical cord insertion and screening for vasa praevia
- Uterine artery Doppler assessment to evaluate placental function
This scan plays a crucial role in identifying conditions that may benefit from closer monitoring or early intervention.
Absolutely not. The term “anomaly scan” is unfortunately often interpreted too literally, leading many providers to focus almost exclusively on fetal anatomy. From a parent’s perspective, the key question is not simply whether the baby’s anatomy appears normal, but whether the pregnancy as a whole is healthy and likely to result in a safe, healthy outcome at birth.
Assessment of fetal anatomy and exclusion of structural abnormalities is important, but it represents only one component of a comprehensive mid-pregnancy evaluation. Many conditions that significantly affect pregnancy outcome are not related to fetal anatomy and will be missed if the scan is limited to a purely anatomical checklist.
A high-quality anomaly scan should also include careful assessment of the placental location, appearance, and features suggestive of placental insufficiency. A healthy pregnancy requires not only a healthy baby, but also a healthy placenta. Similarly, evaluation of the umbilical cord is essential, as cord abnormalities can have serious implications for the baby, for example in conditions such as vasa praevia. The 20-week scan also provides a valuable opportunity to assess the risk of preterm birth through cervical length measurement.
At The Pregnancy Clinic, the advanced anomaly scan is therefore designed as a comprehensive, holistic assessment of the pregnancy, one that integrates fetal anatomy with placental health, cord assessment, and preterm birth risk. This allows families to receive meaningful reassurance about the overall health and wellbeing of the pregnancy, not just a structural check of the baby.
Genetic or “soft” markers are subtle ultrasound findings seen during the detailed anomaly scan. On their own, they are not structural abnormalities and usually represent minor variations from what is considered a typical anatomical appearance.
In most cases, these markers have no impact on the baby’s health and simply reflect normal variation in development. However, some soft markers can be associated with certain genetic or chromosomal conditions, particularly if more than one marker is present or if there are other risk factors.
It is important that these markers are carefully assessed during the detailed ultrasound scan. When no soft markers are seen, and the baby’s anatomy appears normal, this is very reassuring and significantly reduces the likelihood of an underlying genetic concern.
If a soft marker is identified, this does not automatically mean that there is a problem. In such situations, a discussion with a Fetal medicine specialist is helpful to explain the finding in context, taking into account the rest of the scan, previous screening results, and individual risk factors and to advise whether any further tests or follow-up are needed.
Importantly, soft markers are not uncommon, and in the vast majority of pregnancies they are of no clinical significance, representing normal variations in fetal development rather than evidence of disease.
The accuracy of an anomaly scan depends not only on the quality of the ultrasound equipment, but crucially on the skill and expertise of the person performing and interpreting the scan. Even in expert hands, a detailed mid-pregnancy anomaly scan can identify most, but not all, fetal abnormalities.
This is because fetal development is still ongoing at 20 weeks. While many organs are well formed by the second trimester, some continue to develop, mature, or change in appearance and function later in pregnancy. As a result, certain conditions may only become apparent in the third trimester, despite a thorough and normal mid-pregnancy scan.
For this reason, a comprehensive approach to pregnancy care does not rely on a single scan alone. Re-assessment of fetal anatomy and wellbeing later in pregnancy in the third trimester provides additional reassurance for most parents and reduces the risk of unexpected findings after birth. Importantly, it also allows conditions that do emerge later to be identified early enough for appropriate planning and timely management, both during pregnancy and after delivery.
In summary, a normal anomaly scan is an excellent and important milestone, but it should be seen as part of an ongoing, expert-led assessment of fetal health throughout pregnancy rather than a guarantee that every possible condition has been excluded.
Amniotic fluid is primarily made up of the baby’s urine and circulates continuously through the baby’s body. It is produced by the baby’s kidneys, swallowed, and then absorbed through the intestines.
- A normal amniotic fluid volume suggests normal kidney function and overall fetal wellbeing
- Reduced fluid levels can sometimes suggest reduced placental function or, less commonly, a problem with the baby’s kidney function. In certain situations, it may also occur if membranes have ruptured earlier than expected. This is often associated with leakage of fluid, although in some cases the loss of fluid may be subtle and not immediately obvious
- Excessive fluid can also be associated with certain fetal or maternal conditions
Assessing amniotic fluid provides important information about both the baby’s health and placental function.
The placenta (afterbirth) is a pregnancy-specific organ that connects the baby’s circulation to the mother’s. It can be attached to the front (anterior), back (posterior), or sides of the womb (lateral).
At the anomaly scan, particular attention is paid to the distance between the placental edge and the cervix:
- If the placental edge lies within 20 mm of the cervix at 20 weeks, it is described as a low-lying placenta
- This is relatively common and in around 90% of cases, the placenta moves upwards as the womb grows
- If the placenta remains within 20 mm of, or covers, the cervix later in pregnancy, this is called placenta praevia
Placenta praevia carries a risk of bleeding during labour and usually requires delivery by caesarean section. At The Pregnancy Clinic, we routinely check for this as early identification allows safe planning and pregnancy monitoring.
The umbilical cord normally inserts into the central portion of the placenta. In some pregnancies, it may insert:
- At the edge of the placenta (marginal insertion), or
- Into the membranes outside the placental tissue (velamentous cord insertion)
When a velamentous cord insertion occurs in the lower part of the womb, exposed fetal blood vessels may cross near the cervix. This condition is known as vasa praevia.
- These unprotected vessels are at risk of rupture during labour or when membranes rupture
- Undiagnosed vasa praevia is associated with serious risk to the baby
- When identified antenatally, careful monitoring and planned delivery lead to excellent outcomes
At The Pregnancy clinic, this is part of the detailed assessment as a focused ultrasound assessment of cord insertion can reliably confirm or exclude this condition.
An abnormally invasive placenta occurs when the placenta attaches too deeply into the muscle of the womb and does not separate normally after birth.
- This can result in severe, life-threatening bleeding at delivery
- The strongest risk factor is a previous caesarean section, particularly when the placenta lies over the scar
At the anomaly scan, special attention is given to the relationship between the placenta and any previous uterine scar. If abnormal attachment is suspected, early referral to a specialist maternity centre is essential to ensure safe pregnancy and delivery planning.
Doppler ultrasound is a specialised technique used to assess blood flow within blood vessels.
- The uterine arteries supply blood from the mother to the placenta
- Doppler assessment measures the resistance and pattern of blood flow in these vessels
Increased resistance is associated with placental insufficiency, which can increase the risk of:
- Pre-eclampsia
- Fetal growth restriction
At The Pregnancy Clinic, uterine artery Doppler assessment is routinely included in the anomaly scan to help evaluate placental health and guide personalised pregnancy care.
The third-trimester Growth and Doppler scan is designed to assess your baby’s growth, wellbeing and placental function during later stages of the pregnancy. The key objectives of the scan include:
- Estimating fetal weight and assessing growth over time
- Evaluating placental blood flow using Doppler ultrasound
- Measuring amniotic fluid volume
- Reassessing fetal anatomy and development, where appropriate
- Confirming fetal presentation (head-down or breech), particularly in late pregnancy
- Reviewing placental location
This scan plays an important role in monitoring your baby’s health during the final stages of pregnancy and supports safe, individualised planning for birth.
A baby’s growth potential is influenced mainly by two factors:
- Parental constitution and genetics, which contribute to baby’s expected size
- Placental health and function, which affects transfer of oxygen and nutrients
At the time of the 20-week anomaly scan, most babies are of similar size regardless of parental build. For this reason, estimated weight at 20 weeks does not reliably predict birthweight. Growth assessments in the third trimester, particularly closer to term, provides a much more accurate reflection of growth potential.
When placental function is reduced, growth may be limited, leading to a smaller baby. In contrast, some pregnancies, such as those affected by diabetes, may be associated with increased growth.
Monitoring fetal growth in the third trimester helps identify babies who are smaller or larger than expected for gestational age. Significant deviations from expected growth may be associated with an increased likelihood of complications around the time of birth.
Babies who are significantly small or large are more likely to require closer monitoring. Early identification allows appropriate surveillance, timely referral where needed and personalised plan for ongoing care and delivery.
Most babies who are small (<10th centile) or large (>90th centile) for gestational age are healthy and have good outcomes.
- Many small babies are constitutionally small and require reassurance rather than intervention
- Babies who are smaller may have reduced natural reserves and may benefit from additional monitoring to understand the underlying cause and guide delivery planning
- Babies with more significant growth restriction may require specialist input and a tailored management plan
Similarly, most larger babies are healthy. In pregnancies complicated by diabetes, closer monitoring is recommended. Where babies are large without diabetes, discussing delivery options helps support informed decision-making.
Amniotic fluid reflects fetal wellbeing and placental function.
- Normal fluid levels are generally reassuring
- Reduced fluid may indicate placental insufficiency or leaking of waters
- Increased fluid is often a normal variation but may occasionally be associated with maternal or fetal conditions such as diabetes, infection or less commonly in some instances, birth defects
Any variation in amniotic fluid volume is interpreted alongside other scan findings and the overall clinical picture.
Doppler ultrasound is a specialised technique used to assess blood flow in key fetal and placental blood vessels. During growth scans, Doppler assessment helps evaluate placental function and how baby is adapting to the pregnancy. Commonly assessed vessels include:
- Umbilical artery, reflecting resistance to blood flow across the placenta
- Middle cerebral artery (brain), which can indicate fetal adaptation to reduced oxygen supply
- Ductus venosus (near the heart), assessed in selected cases to reflect fetal heart function
Doppler findings are particularly valuable in the third trimester and may influence monitoring strategies and timing of delivery.
Fetal position changes frequently throughout the pregnancy.
- Breech presentation is relatively common earlier in third trimester
- By 36 weeks, most babies have turned head down
If a baby remains breech at around 36 weeks, this scan provides an opportunity to discuss management options and plan appropriately for delivery.
Growth scans can be performed from 26–28 weeks onwards.
- In pregnancies with additional risk factors, scans may be recommended every 2–3 weeks
- In pregnancies without identified risk factors, scans can be performed every 4 weeks
If only one third-trimester scan is undertaken, evidence supports performing it between 35 and 37 weeks, when it provides the most clinically useful information.
Yes. While the 20-week anomaly scan is the optimal time to assess the baby’s anatomy in detail, the baby continues to grow and develop throughout pregnancy. A scan in the late third trimester, around 36 weeks, provides important additional information about the baby’s growth, wellbeing and readiness for birth.
One of the key purposes of the 36-week scan is to assess fetal growth. Some babies may be smaller or larger than expected for gestational age, and identifying this allows appropriate monitoring and planning of delivery if needed. Early recognition of growth concerns helps ensure that babies receive the right care at the right time. In some pregnancies there may be early changes in blood flow patterns, including in the baby’s brain, particularly when placental function is reduced. These changes can occur even when the baby’s size appears normal, and their detection helps guide monitoring and delivery planning.
The scan also reassesses aspects of the baby’s anatomy and development. Although major structural conditions are usually identified at the 20-week anomaly scan, some findings only become apparent later in pregnancy as organs mature and develop further. A late pregnancy review therefore provides an additional opportunity to identify conditions that may influence newborn care or postnatal follow-up.
Another important aspect of the scan is confirming the baby’s presentation, specifically whether the baby is head down or breech, which can influence planning for labour and delivery.
The scan also evaluates the amniotic fluid levels, as both reduced and excessive fluid can require closer monitoring and discussion about the safest timing and mode of delivery.
Overall, the 36-week scan provides a final comprehensive assessment of growth, wellbeing and pregnancy conditions, helping ensure that the most appropriate plan is in place for labour, delivery and care of the baby after birth.
Non-invasive prenatal testing (NIPT) is a blood test performed during pregnancy to screen for certain genetic conditions affecting the baby. The test analyses small fragments of placental DNA circulating in the mother’s bloodstream, and because it only requires a blood sample from the mother, it poses no physical risk to the pregnancy.
In pregnancy, NIPT is most commonly used to screen for the genetic conditions caused by an extra copy of a chromosome (trisomy), including Down syndrome (Trisomy 21), Edwards syndrome (Trisomy 18) and Patau syndrome (Trisomy 13). More advanced forms of NIPT are also available that can screen for additional genetic conditions, including certain microdeletions (small missing sections of chromosomes) and, in some tests, rarer conditions caused by changes in single genes.
The main advantage of NIPT is that it is a highly accurate screening test, detecting the common trisomies with greater than 99% sensitivity for Down syndrome, while avoiding the small miscarriage risk associated with invasive diagnostic tests. However, it is important to remember that NIPT is a screening test rather than a diagnostic test, and any high-risk result may require confirmation with further testing.
Non-invasive prenatal testing (NIPT) is primarily used to screen for chromosomal conditions that can affect the baby during pregnancy. A standard NIPT screens for the most common chromosomal conditions caused by an extra copy of a chromosome, known as trisomies, including:
- Down syndrome (Trisomy 21)
- Edwards syndrome (Trisomy 18)
- Patau syndrome (Trisomy 13)
Many NIPT tests also include screening for sex chromosome conditions, such as:
- Turner syndrome (Monosomy X)
- Klinefelter syndrome (XXY)
- Jacobs syndrome (XYY)
- Triple X syndrome (XXX)
More advanced NIPT panels can also screen for selected microdeletion syndromes, which occur when a small section of a chromosome is missing. Examples commonly included in expanded panels include:
- 2 deletion syndrome (DiGeorge syndrome)
- 5p deletion syndrome (Cri-du-Chat syndrome)
- 4p deletion syndrome (Wolf–Hirschhorn syndrome)
- 1p36 deletion syndrome
- 2 deletion syndromes (Prader–Willi / Angelman region)
- 11q deletion syndrome (Jacobsen syndrome)
Some specialised laboratories also offer expanded panels that include selected single-gene disorders, although these tests are more specialised and are usually considered in specific clinical circumstances.
At The Pregnancy Clinic, we offer the full range of NIPT options. An essential part of this process is careful pre-test counselling, which helps determine the most appropriate type of NIPT for your circumstances. Post-test counselling is also provided so that results are interpreted clearly and meaningfully, ensuring that you understand what the results mean and what the next steps may be if further assessment is required.
NIPT is the most accurate screening test currently available for the common chromosomal conditions in pregnancy. It detects more than 99% of babies with Down syndrome, with a very low false-negative rate (less than 1%) and a false-positive rate of around 0.1–0.3%. In comparison, traditional first-trimester combined screening detects about 85–90% of Down syndrome cases, meaning around 10–15% may be missed.
NIPT is also a very effective screening test for sex chromosome conditions such as Turner, Klinefelter, XYY and Triple X syndromes, with detection rates generally above 95–99% depending on the condition.
Some expanded NIPT panels can also screen for microdeletion syndromes (such as DiGeorge syndrome) and selected single-gene conditions, although the accuracy for these rarer conditions is less well established than for the common trisomies.
Overall, NIPT provides very high screening accuracy for the most common chromosomal conditions, but it remains a screening test rather than a diagnostic test, so any high-risk result usually requires confirmation with diagnostic testing.
No. NIPT screens for a limited number of relatively common genetic conditions, most commonly the trisomies such as Down syndrome, Edwards syndrome and Patau syndrome, and in some cases certain sex chromosome conditions or selected microdeletions.
While NIPT is extremely effective at screening for these specific conditions, there are hundreds of other rare genetic conditions that it does not assess. A normal (low-risk) NIPT result therefore does not exclude all possible genetic or developmental conditions.
For this reason, detailed ultrasound assessment remains an essential part of pregnancy care. Scans such as the Nuchal scan at 12 weeks and the Anomaly scan at 20 weeks evaluate the baby’s anatomy and development in detail. These scans can sometimes identify findings that may be associated with a wider range of genetic conditions that are not detectable by NIPT.
If ultrasound findings raise concerns, further investigations may be recommended. These may include diagnostic tests such as amniocentesis or chorionic villus sampling, with advanced genetic analysis such as chromosomal microarray testing or whole exome sequencing, which can assess a much broader range of genetic conditions.
For this reason, NIPT and detailed ultrasound scans are complementary, and both play an important role in providing a comprehensive assessment of pregnancy health.
No. NIPT is a screening test, not a diagnostic test. It estimates the chance that the baby may have certain genetic conditions but does not provide a definitive diagnosis.
A low-risk result is very reassuring and makes the screened conditions highly unlikely, but it does not completely exclude them. There are also many other genetic conditions that NIPT does not assess, as it screens only for a limited number of relatively common chromosomal abnormalities.
A high-risk result does not confirm that the baby has the condition. It indicates that the chance is increased and therefore requires confirmation with diagnostic testing, such as chorionic villus sampling (CVS) or amniocentesis, which analyse the baby’s genetic material directly.
The limitations of NIPT are particularly relevant when screening for microdeletions or rarer genetic changes, where detection rates and accuracy are lower than for the common trisomies. For this reason, NIPT should be considered complementary to detailed ultrasound assessment, rather than a replacement for it.
Detailed scans such as the Nuchal scan at 12 weeks and the Anomaly scan at 20 weeks remain essential because they assess the baby’s development and can identify findings associated with a much wider range of genetic conditions that may then be investigated with diagnostic genetic testing if required.
Specialist counselling before and after the NIPT is important because it helps ensure that the most appropriate test is chosen and that the results are interpreted correctly within the context of your pregnancy. At The Pregnancy Clinic, NIPT is always supported by both pre-test and post-test consultation with a fetal medicine specialist.
Pre-test counselling is important because it allows discussion of:
- Whether NIPT is appropriate for your individual pregnancy, particularly in the context of previous pregnancy history or ultrasound findings
- Which type of NIPT panel may be most suitable, as different tests screen for different conditions
- What the test can and cannot detect, including its limitations
- How NIPT complements ultrasound assessment, rather than replacing it
Post-test counselling is equally important to ensure that the results are interpreted accurately and meaningfully. This discussion helps explain:
- What a low-risk result means and its reassuring implications
- What a high-risk result means and the need for confirmatory diagnostic testing, such as chorionic villus sampling (CVS) or amniocentesis
- How the results should be interpreted alongside ultrasound findings and overall pregnancy risk
For these reasons, NIPT is best offered as part of a consultant-led assessment, where appropriate counselling ensures that testing is used safely and that families are supported in understanding both the benefits and limitations of the test.
Yes. A low-risk NIPT result is reassuring, but it does not replace the need for detailed ultrasound scans during pregnancy.
NIPT is designed to screen for certain genetic conditions, such as Down syndrome, Edwards syndrome and Patau syndrome, and in some tests selected sex chromosome conditions or microdeletions. However, it does not assess how the baby is developing structurally and does not evaluate the placenta or many other aspects of pregnancy health.
There are hundreds of genetic and developmental conditions that NIPT does not screen for. Many important conditions affecting the brain, heart, spine and other organs are detected only through detailed ultrasound assessment.
For this reason, scans such as the Nuchal scan at 12 weeks and the Anomaly scan at 20 weeks remain essential parts of pregnancy care. These scans assess the baby’s anatomy, development and placental function, and can sometimes identify findings associated with genetic conditions that may require further investigation with diagnostic tests such as chorionic villus sampling (CVS) or amniocentesis.
In this way, NIPT and ultrasound scans are complementary. NIPT provides highly accurate screening for certain chromosomal conditions, while ultrasound remains the main method for assessing the baby’s development and overall pregnancy wellbeing.
NIPT can usually be performed from 10 weeks of pregnancy onwards, when there is sufficient placental DNA circulating in the mother’s bloodstream for reliable analysis.
An ultrasound scan before the test is an important part of the assessment. The scan confirms the gestational age, fetal growth and overall development of the pregnancy, and ensures that the timing of the test is appropriate. Performing NIPT too early in pregnancy may result in insufficient placental DNA in the maternal blood, which can lead to an inconclusive result or the need for repeat testing.
In some circumstances, testing for the baby’s sex can be performed earlier, typically from around 7 weeks of pregnancy, although this depends on the specific test used.
Your consultant will advise on the most appropriate timing for NIPT based on the ultrasound findings, gestational age and your individual screening pathway, ensuring that the test is performed at the time when it is most likely to provide a reliable result.
Results are typically available within 5–7 working days from the blood sample being taken.
In a small proportion of cases, usually around 3–4%, NIPT may not provide a result. This is most commonly due to low levels of placental DNA (fetal fraction) in the mother’s blood at the time of testing.
There can be several reasons for a failed or inconclusive test, including testing too early in pregnancy, naturally low fetal fraction, higher maternal weight, certain technical factors in the sample, or rarely other biological reasons. Importantly, a failed result does not necessarily mean that there is a problem with the pregnancy. If this occurs:
- The test can often be repeated at a later stage of pregnancy, when placental DNA levels may be higher
- Your consultant may discuss alternative screening options
- In some situations, diagnostic testing may be considered depending on the clinical context
This possibility and the appropriate next steps are discussed during the consultation before testing, so that you are fully informed about how results are interpreted and managed.
All NIPT results at The Pregnancy Clinic are reviewed and explained by a Consultant in Fetal–Maternal Medicine. The results are interpreted in the context of your ultrasound findings, gestational age, and overall screening pathway, ensuring that they are understood clearly and meaningfully.
During the discussion, your consultant will explain what the result means, the degree of reassurance it provides, and the limitations of the test. If the result indicates a low chance, this will be discussed alongside the role of ongoing ultrasound scans in monitoring the baby’s development.
If the result indicates a higher chance, or if the test result is inconclusive, your consultant will explain the possible reasons and discuss the appropriate next steps, which may include repeat testing or diagnostic tests such as chorionic villus sampling (CVS) or amniocentesis.
This consultant-led counselling ensures that results are interpreted safely and that you receive clear guidance and support in deciding the most appropriate plan for your pregnancy.
Pre-conception counselling provides an opportunity to prepare for pregnancy in the safest and most informed way, helping to optimise health and reduce potential risks before conception occurs.
During the consultation you can:
- Understand and reduce potential pregnancy risks based on your medical, obstetric, and family history
- Optimise health, medications, and supplements to ensure they are safe and appropriate for pregnancy
- Develop a personalised plan for conception, early pregnancy care, and screening
- Gain reassurance, clarity, and confidence as you plan the next steps in your pregnancy journey
This consultation helps ensure that pregnancy begins with the best possible preparation and support, particularly for those with previous pregnancy complications or specific medical considerations.
Pre-conception counselling can be beneficial for anyone planning a pregnancy who wishes to optimise their health and improve pregnancy outcomes. It is particularly helpful if you:
- Are planning your first pregnancy and would like guidance on preparing for conception
- Have experienced recurrent miscarriage
- Previously had a baby with a birth defect or structural condition
- Have had a pregnancy affected by a genetic condition
- Developed preeclampsia or high blood pressure in a previous pregnancy
- Have had a preterm birth or cervical surgery
- Have a medical condition, such as diabetes, thyroid disease, hypertension, autoimmune disorders, cardiac conditions, or neurological conditions
- Take long-term medications that may need review before pregnancy
- Would like expert reassurance and a personalised plan before trying to conceive
A pre-pregnancy consultation allows time to review your medical and pregnancy history, optimise health, and develop a tailored plan for conception and early pregnancy care.
A pre-conception consultation provides a comprehensive review of your health, previous pregnancy history, and factors that may influence a future pregnancy, allowing time to plan care in a thoughtful and personalised way.
Your private pre-pregnancy consultation typically includes:
- A detailed review of your medical, surgical, gynaecological and obstetric history
- Discussion of family history, including any genetic or inherited conditions
- Assessment of previous pregnancy complications, such as miscarriage, stillbirth, preterm birth, preeclampsia or fetal growth restriction
- Medication review, including optimisation of long-term medications to ensure they are safe for pregnancy
- Individualised assessment of potential pregnancy risks
- Advice on nutrition, weight, lifestyle and pre-pregnancy health optimisation
- Guidance on recommended supplements, including folic acid and vitamin D
- Planning of blood tests, genetic screening, scans or specialist referrals, where appropriate
- Development of a personalised pre-pregnancy and early pregnancy care plan
Following the consultation, you will receive a detailed written summary outlining the discussion, recommendations and next steps, helping you move forward with clarity and confidence when planning your pregnancy.
At The Pregnancy Clinic, pre-conception counselling can be tailored to specific medical or pregnancy histories that may influence future pregnancies. These specialist pathways allow time to review previous outcomes, assess potential risks, and develop an evidence-based plan to optimise pregnancy health from the outset.
Our specialist pre-conception pathways include:
Recurrent miscarriage history
Specialist counselling for women with two or more pregnancy losses, including review of previous investigations and planning of early pregnancy monitoring and care.
Previous birth defect or genetic condition
Pre-conception consultation following a pregnancy affected by a major structural birth defect or genetic condition, with discussion of recurrence risks, available screening or diagnostic options, and strategies for monitoring future pregnancies.
Pre-eclampsia prevention
Counselling for women who have previously experienced preeclampsia or hypertensive disorders of pregnancy, focusing on evidence-based prevention strategies, risk assessment and planning of appropriate surveillance.
Preterm birth and cervical insufficiency
Pre-pregnancy consultation for women with a history of preterm birth, cervical surgery, or cervical insufficiency, including discussion of surveillance strategies and preventive treatments such as progesterone therapy or cervical cerclage where appropriate.
Pregnancy planning with medical conditions
Pre-conception counselling for women with pre-existing medical conditions such as diabetes, thyroid disease, hypertension, autoimmune disorders, or cardiac or neurological conditions. This includes optimisation of medications and coordinated care planning to support a safe and healthy pregnancy.
At The Pregnancy Clinic, our focus is on providing expert, consultant-led care in a calm and supportive setting, with time to listen, explain and guide you through each stage of pregnancy. Our approach combines advanced screening, detailed ultrasound assessment and personalised consultations to help identify potential concerns early and support the healthiest possible pregnancy.
Patients choose The Pregnancy Clinic because we offer:
- Consultant-led, one-to-one private antenatal care
- Continuity of care with experienced fetal–maternal medicine specialists
- Proactive screening and risk assessment for pregnancy complications
- Early identification and evidence-based management of pregnancy concerns
- High standards of ultrasound assessment for fetal and placental conditions
- A calm, discreet and supportive environment for consultations and scans
- A service trusted by women and families across Sevenoaks, Kent and London
Our aim is to provide clear information, thoughtful care and reassurance, helping you feel confident and supported throughout your pregnancy journey.
Consultant-led private antenatal care is often chosen by women who value continuity, expertise, and a proactive approach to pregnancy care. It can be particularly reassuring for those who wish to have more time for discussion, detailed assessment, and personalised planning throughout pregnancy.
Women who choose this type of care often:
- Value continuity of care with experienced consultant specialists
- Prefer a proactive and preventive approach to pregnancy health
- Recognise that pregnancy complications can arise by chance, even in otherwise healthy pregnancies
- Appreciate the importance of early screening, timely diagnosis, and evidence-based management
- Would like more time for detailed consultations, explanations, and reassurance
This approach provides individualised care and careful monitoring, helping ensure that any concerns are identified early and managed appropriately.
Our Private Antenatal Care package is designed to provide comprehensive, consultant-led care throughout pregnancy, combining detailed consultations, advanced ultrasound assessment and personalised investigations. The aim is to ensure that every aspect of the pregnancy is reviewed carefully, with time for explanation, reassurance and proactive management where needed.
The package typically includes:
Comprehensive pregnancy consultations with continuity of care
- In-depth consultant-led consultations at key stages of pregnancy
- Ongoing review and discussion of scan findings, blood tests and investigations
- Continuity of care with the same consultant, allowing a personalised understanding of your pregnancy
- Evidence-based counselling and clear explanations, supporting informed decisions throughout pregnancy
Detailed pregnancy scans
- Consultant-performed ultrasound scans throughout pregnancy
- High-quality imaging with expert interpretation
- Screening for genetic conditions and structural birth defects
- Assessment of placental position and placental function
- Surveillance for pregnancy complications such as fetal growth restriction, preeclampsia, preterm birth risk, placenta praevia and vasa praevia
Blood tests and pregnancy investigations
- Screening and diagnostic blood tests tailored to the pregnancy
- Targeted investigations based on gestation, clinical findings and evolving risk factors
- Consultant interpretation of results with clear discussion of their implications
- Early identification of potential complications, allowing timely monitoring and treatment when required
This structured, consultant-led approach allows pregnancy care to be thoughtful, proactive and personalised, ensuring that any concerns are recognised early and that you feel well informed and supported throughout your pregnancy journey.
Our consultant-led Private Antenatal Care pathway provides a structured programme of screening and monitoring designed to identify conditions that may affect the health of the mother or baby during pregnancy. While most pregnancies progress normally, certain complications can arise by chance, and early identification allows timely monitoring, treatment and delivery planning.
This pathway combines specialist consultations, detailed ultrasound assessment and targeted investigations at key stages of pregnancy, allowing proactive and personalised care.
Genetic and chromosomal conditions
Screening for common chromosomal conditions such as Down syndrome, Edwards syndrome and Patau syndrome, with the option of non-invasive prenatal testing (NIPT) alongside detailed first-trimester assessment at the nuchal scan.
Structural birth defects
Comprehensive evaluation of the baby’s anatomy through specialist ultrasound scans, including early anatomy assessment in the first trimester and a detailed anomaly scan at around 20 weeks, which assesses the development of major organs such as the brain, heart, spine, kidneys and abdominal structures.
Fetal growth and placental function
Surveillance for conditions affecting fetal growth and placental health, including:
- Small for gestational age babies
- Large for gestational age babies
- Placental insufficiency
This includes monitoring of fetal growth patterns, amniotic fluid levels and Doppler blood flow assessments where appropriate.
Maternal pregnancy complications
Screening and surveillance for important pregnancy-related conditions, including:
- Preeclampsia and hypertensive disorders of pregnancy
- Gestational diabetes
- Maternal anaemia and iron deficiency
- Risk of preterm birth and cervical insufficiency
- Placental conditions such as placenta praevia and vasa praevia
Importantly, the pathway does not stop at risk assessment alone. When an increased risk is identified, our focus is on early identification of potential complications, evidence-based monitoring and preventive strategies and timely treatment and intervention where appropriate.
- This service provides planned private antenatal care only
- This service does not include private labour or delivery care
- All deliveries take place within NHS maternity services
Our clinic does not provide emergency, urgent, or out-of-hours care. Any acute concerns should be directed to:
- All emergency, urgent, and out-of-hours care must be accessed via your local NHS maternity provider or emergency services
- Your local NHS maternity unit
- Your GP or NHS 111 or emergency services, as appropriate
Private postnatal care at The Pregnancy Clinic is suitable for anyone who would like a comprehensive review of their health and pregnancy after delivery, particularly if there were medical or pregnancy-related complications.
This service may be especially helpful if you:
- Experienced preeclampsia, gestational hypertension, or raised blood pressure during pregnancy
- Were diagnosed with gestational diabetes
- Had a pregnancy affected by preterm birth, fetal growth restriction, or stillbirth
- Required an emergency or operative delivery, such as assisted vaginal birth or caesarean section
- Have pre-existing medical conditions that can influence pregnancy health
- Have a history of recurrent pregnancy complications
- Are planning another pregnancy and would like personalised advice on risk reduction and preparation
- Would value a detailed consultant-led postnatal review beyond routine postnatal checks
The consultation provides an opportunity to review what happened during pregnancy and birth, assess ongoing health considerations, and plan confidently for future pregnancies if desired.
Our Private Postnatal Care service provides a comprehensive consultant-led review following pregnancy and delivery. The consultation allows time to discuss your recovery, review any complications that occurred during pregnancy or birth, and consider any implications for your long-term health or future pregnancies. The service typically includes:
6-Week Postnatal Consultant Review
- Comprehensive review of pregnancy, delivery, and postnatal recovery
- Assessment following vaginal birth or caesarean section
- Review of blood pressure, metabolic health, and relevant investigations
- Medication review, contraception advice, and ongoing symptom assessment
Pregnancy and Birth Debrief
- Clear explanation of events during pregnancy, labour, and delivery
- Review of diagnoses such as pre-eclampsia, gestational diabetes, fetal growth restriction, preterm birth, or operative delivery
- Opportunity to ask questions and address unresolved concerns
- Supportive discussion following complex, unexpected, or traumatic experiences
Specialist Consultations and Investigations (If Clinically Indicated)
- Targeted investigations based on pregnancy history and clinical need
- Interpretation of results within the context of pregnancy-related risk
- Advice regarding onward referral to urogynaecology, endocrinology, haematology, or other specialties when appropriate
Future Pregnancy Planning
- Personalised assessment of recurrence risk for pregnancy complications
- Evidence-based strategies for risk reduction and optimisation prior to conception
- Clear guidance on recommended surveillance and care pathways in future pregnancies
Long-Term Health and Well-Being
- Discussion of longer-term implications of pregnancy complications
- Cardiovascular and metabolic risk counselling where relevant
- Practical advice on lifestyle modification, including diet, exercise, weight management, and blood pressure control
- Guidance on appropriate follow-up with your GP or NHS services
Our clinic does not provide emergency, urgent, or out-of-hours care. Any acute concerns should be directed to:
- All emergency, urgent, and out-of-hours care must be accessed via your local NHS maternity provider or emergency services
- Your local NHS maternity unit
- Your GP or NHS 111 or emergency services, as appropriate