Pregnancy Tiffa/anomaly (level 2) Ultrasound Scan

Why this scan is a crucial milestone in pregnancy

• Detects up to 80 % of major structural birth defects.
• Offers the clearest view of your baby’s brain, heart, spine, and limbs.
• Helps your obstetrician plan any special care you or your baby may need.

Quick facts and key takeaways

• When: 18–22 weeks (best at 20 weeks).
• Duration: 30–45 minutes.
• Safety: No radiation; no known risks.
• Results: Same-day digital report and images.

TIFFA acronym explained: Targeted Imaging for Fetal Anomalies

TIFFA isn’t just another scan—it’s a targeted, head-to-toe survey of every organ system to rule out or confirm anomalies.

Difference between level 1 and level 2 ultrasound

How 2D, 3D and color Doppler enhance the scan

• 2D: Gold-standard diagnostic images.
• 3D/4D: Surface rendering for clearer facial views and parental bonding.
• Color Doppler: Evaluates blood flow in umbilical cord, heart, and brain.

Transabdominal standard TIFFA

Most common approach; gel on the belly, painless probe movements.

Transvaginal TIFFA (if better resolution required)

Occasionally used for very detailed brain or cervical assessment—always with consent.

3D/4D add-on enhancements

Optional yet popular; ideal for family keepsake images without compromising diagnostic accuracy.

• Brain: ventricles, posterior fossa, corpus callosum
• Face: lips, palate, nasal bone
• Heart: 4-chamber view, outflow tracts, septa
• Spine: integrity and curvature
• Abdomen: stomach, kidneys, bladder, cord insertion
• Limbs: long bones, digits
• Placenta: position, maturity, Doppler flows
• Amniotic fluid volume assessment

• Identify structural birth defects early.
• Check fetal growth against gestational age.
• Guide further invasive or non-invasive testing decisions.

Ideal gestational age: 18–22 weeks (optimal 20 weeks)

At this stage, your baby is large enough for detail but still surrounded by enough fluid for clear views.

High-risk maternal or family history indications

• Advanced maternal age (≥ 35 years).
• Family history of congenital anomalies.
• Pre-existing diabetes or hypertension.

Multiple pregnancy considerations

Twins or triplets require extra time and expertise; Cadabams’ sonographers are specially trained for multi-fetal scans.

• Early reassurance or timely intervention if needed.
• Birth planning for specialized delivery or neonatal care.
• Parental psychological preparedness—knowing what to expect.

• Neural tube defects (spina bifida, anencephaly)
• Congenital heart disease
• Cleft lip/palate
• Renal agenesis or obstruction
• Skeletal dysplasias

• Hydration: Drink 500 ml water 30 minutes prior (full bladder may be required).
• Clothing: Wear a loose 2-piece outfit for easy abdomen access.
• Carry: Previous scan reports and obstetric notes.

• Referral from obstetrician.
• Confirmed gestational age via earlier dating scan.

• Window 18–22 weeks for highest diagnostic accuracy.
• Avoid after 24 weeks—structures become less visible due to ossification.

• All pregnant women as routine antenatal care.
• Higher priority for AMA (>35 yrs), diabetes, previous anomaly.

1. Check-in & verification of identity.
2. Lie on scan couch, gel applied to abdomen.
3. Duration: 30–45 minutes depending on fetal cooperation.
4. Real-time discussion of findings with radiologist.

• Inform sonographer of any implanted devices or scars.
• Report vaginal bleeding or pain immediately.

No known harm: ultrasound safety profile

Extensive research shows no harmful effects to mother or baby.

Limitations

• Maternal obesity can reduce image clarity.
• Fetal position may hide certain structures.
• Equipment quality matters—Cadabams uses high-resolution machines to minimise these issues.

When additional genetic tests may still be needed

Soft markers or inconclusive findings may prompt NIPT, amniocentesis, or repeat imaging.