Anomaly Scan and Pregnancy Ultrasounds in Pakistan: Timing, Cost and What Each Scan Checks
Anomaly scan in Pakistan: when it is done, what it checks, what it costs, and how the dating, NT and growth scans fit around it.
Your doctor hands you a slip that says "Level II scan, 20 weeks" and moves on to the next patient. You get home, search it, and every page that comes up is British or American. Nobody tells you what the scan actually looks at, why 20 weeks and not 24, or whether Rs 5,000 at the lab down the road is a fair price.
Here is the Pakistani version. What each pregnancy ultrasound is for, when it has to happen, what it costs at the big labs right now, and which ones matter most if you can only afford a few.
What an anomaly scan is
The anomaly scan is the detailed ultrasound of your baby's anatomy, done in the middle of pregnancy. In Pakistan you will hear it called the Level II scan, the anatomy scan or the 20-week scan. They are the same thing.
The NHS does this scan between 18 and 21 weeks, and up until 23 weeks in some cases. It takes around 30 minutes. Cleveland Clinic gives the window as 18 to 22 weeks and says to expect about 45 minutes, usually as its own appointment rather than tacked onto a routine check.
That timing is not arbitrary. Before 18 weeks the organs are too small to see clearly. Much after 22 weeks the baby is bigger, more curled up, and harder to photograph from every angle. Miss the window and you do not get a second chance at the same quality of picture.
What the sonographer is actually looking at
Cleveland Clinic lists the checks: the heart, brain, head, neck, spine, kidneys, bladder, limbs, hands, feet, facial features, chest, lungs, stomach and intestines. They also measure limb length, head size and belly circumference, record the heart rate, look at blood flow through the umbilical cord, check where the placenta has attached, measure the amniotic fluid, and look at your uterus, ovaries and cervix.
The NHS scan screens specifically for 11 conditions: anencephaly, open spina bifida, cleft lip and palate, diaphragmatic hernia, gastroschisis, exomphalos, serious cardiac abnormalities, bilateral renal agenesis, severe skeletal dysplasia, Edwards' syndrome and Patau's syndrome.
Most of the appointment is measurement, not drama. A sonographer who goes quiet for a few minutes is usually just trying to get a clean view of a four-chamber heart while the baby keeps turning away.
The full scan timeline, and what each one costs
| Scan | When | What it answers | Typical price |
|---|---|---|---|
| Early or viability scan | Around 7 to 8 weeks | Is there a heartbeat, is it one baby or more, how far along are you | Around Rs 3,000 |
| Dating scan | 10 to 14 weeks | Confirms your due date and the number of babies | Around Rs 3,000 |
| NT scan | 11 to 14 weeks | Measures fluid at the back of the baby's neck, part of the combined screening test | Around Rs 3,500 |
| Anomaly scan (Level II) | 18 to 22 weeks | Detailed check of the baby's anatomy | Rs 3,400 to Rs 5,000 |
| Growth scan | Usually after 28 weeks | Is the baby growing on track, how is the fluid and the placenta | Around Rs 3,000 |
| Obstetric Doppler | Third trimester, if advised | Blood flow to the baby when growth is a concern | Around Rs 5,000 |
Those price figures come from published rate lists checked in September 2026: Chughtai Lab lists a Level-I pregnancy ultrasound at Rs 3,000, an anomaly scan at Rs 5,000, an NT scan at Rs 3,500 and an obstetric Doppler at Rs 5,000. Islamabad Diagnostic Centre lists its anomaly scan at Rs 3,800, and Diagnostic Plus at Rs 4,400. Private clinics attached to a consultant often charge more, small neighbourhood setups less.
One thing worth knowing before you book: a cheap scan on an old machine with an inexperienced operator is not the same test. The anomaly scan in particular depends heavily on who is holding the probe. If you are choosing where to spend, spend here.
Why the NT scan cannot wait
The dating scan at 10 to 14 weeks is the one that sets your due date, confirms whether you are carrying more than one baby, and takes about 20 minutes. The NT scan usually happens at the same appointment, and it is the one women most often miss, because the window is narrow and early. The NHS combined test pairs a blood test with an ultrasound measurement of the fluid at the back of the baby's neck, and it is usually done between 10 and 14 weeks.
Go past 14 weeks and that option closes. The NHS then offers the quadruple blood test between 14 and 20 weeks instead, and states plainly that it is "not as accurate as the combined test". So if you want this screening, the clock starts the day you find out you are pregnant.
This is exactly where being wrong about your dates costs you. If you are unsure how many weeks along you are, our pregnancy calculator will work it out from your last period, and the ovulation calculator helps if your cycles are irregular and you are not sure when you actually conceived. Take that number to your first appointment rather than guessing.
What the anomaly scan will not tell you
This is the part clinics skip, and it is the part that causes the most heartache later.
Cleveland Clinic puts it directly: a 20-week ultrasound "doesn't find all congenital conditions". The NHS says the same thing in different words, that some conditions can be seen more clearly than others and the scan may not find everything. A normal anomaly scan is genuinely good news. It is not a guarantee.
Two other limits are practical rather than medical. If the baby is lying awkwardly, the sonographer may not be able to complete every view, and Cleveland Clinic notes you may be called back to finish the scan. And it can only see structure. Conditions that involve how a body works rather than how it is built will not show up on any ultrasound.
Will they tell you the sex?
Usually the sonographer can see the genitals at this scan, depending on how the baby is positioned, and the NHS notes you may be asked whether you want to know. Practice varies a lot between clinics in Pakistan, and some will not tell you at all. Ask when you book rather than at the door, so nobody is disappointed.
Is ultrasound safe?
Yes, on the evidence we have. MedlinePlus states that current ultrasound techniques appear to be safe and that ultrasound does not involve radiation. Cleveland Clinic says pregnancy ultrasounds are safe and have no known harmful side effects.
What the same page also says is that one or two scans is typical in an uncomplicated pregnancy, with more added when there is a reason. So the answer to "should I get a 3D scan every month" is that there is no medical reason to. Keepsake scans are a personal spend, not part of your care.
How the scan itself feels
In early pregnancy, before about 12 weeks, the clearest view often comes from a transvaginal scan, with a slim probe inserted into the vagina. After that it is done over your belly. MedlinePlus describes the routine: a clear, water-based gel is spread over your belly and pelvis, then a handheld probe is moved over the area. You do not feel the ultrasound waves at all. If you have been told to come with a full bladder, the pressure is the uncomfortable part, not the scan.
What to sort out alongside the scans
Scans watch. They do not fix anything. The two things you can actually influence between appointments are folate and iron.
Folate matters earliest, well before the anomaly scan can look at the spine. If you are planning a pregnancy or newly pregnant, FOL Chew (Rs 485) is a chewable tablet containing L-methylfolate 400 mcg, the active form of folate, from NB Sons. There is more on how folate works and who needs a higher dose in our guide to folic acid tablets.
Iron becomes the issue later, and it is very common here. Ferosim (Rs 450) uses iron bisglycinate 130 mg with L-methylfolate 200 mcg and vitamin C 50 mg per tablet, a chelated form that is easier on the stomach than older iron salts. The brand advises taking it after food and away from chai, since tea reduces iron absorption. If your haemoglobin has come back low, our CBC test guide explains what those numbers mean, and take any supplement decision in pregnancy to your doctor first.
If you would rather not assemble things piece by piece, the Complete Pregnancy Care bundle (Rs 1,720) puts Movin maternal nutrition, FOL Chew and Greelac lactation support together. Our prenatal vitamins guide compares the options if you want to choose for yourself.
A short checklist before you book
- Know your exact week. Book the NT scan before 14 weeks and the anomaly scan between 18 and 22 weeks.
- Ask who performs the scan, not only what it costs. Experience matters more than the sticker price at this one appointment.
- Ask whether the report is reviewed by a radiologist or consultant, and how soon you get it.
- Ask the clinic's policy on telling you the sex before you go.
- Take your previous reports with you. Comparing growth across scans is the whole point of the later ones.
- Book the anomaly scan as its own appointment. It runs 30 to 45 minutes.
Around 24 to 28 weeks your doctor will usually add the glucose test for gestational diabetes, which is a separate thing from any scan. Our gestational diabetes guide covers what that involves.
If you are earlier than all of this and still working out what your body is telling you, start with early pregnancy symptoms. Everything else in this area sits under women's health.
One last thing. If a scan report comes back with a word you do not recognise, do not spend the night reading forums. Ring the clinic and ask them to explain it in plain Urdu. Most of the frightening-sounding terms on an ultrasound report turn out to be normal variations, and the person who did the scan can tell you which yours is in about two minutes.
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