TTSEO

20-weeks Ultrasound

The 20-weeks ultrasound (TTSEO- Structural Anomaly Scan)

The 20-week ultrasound, also known as the Structural Anomaly Scan or TTSEO, is a medical screening ultrasound performed between 19 and 22 weeks of pregnancy. This detailed scan assesses your baby’s development and checks for potential physical abnormalities. The scan takes approximately 45 to 60 minutes.

More information can be found at pns.nl.

What Is Assessed During the 20-Week Scan?

During this screening, your baby is thoroughly examined. The sonographer will assess:

  • The brain, skull, and face

  • The spine

  • The heart, stomach, intestines, kidneys, and bladder

  • The limbs and overall growth

  • The amniotic fluid volume and placenta location

  • The gender, if you wish to know

What Can (and Can’t) the 20-Week Scan Detect?

✅ Most major physical anomalies can be detected.
❌ Minor anomalies or genetic conditions (e.g., Down syndrome) are not directly assessed. Some features may suggest a syndrome, but further testing would be required.

A normal scan result does not guarantee that your baby is completely healthy, as some conditions are not visible via ultrasound.

Is the 20-Week Scan Optional?

Yes. Just like the NIPT and 13-week ultrasound, this scan is voluntary.
It’s important to consider in advance how you would feel or what you would do in case of an abnormal finding.

Benefits of the 20-Week Scan

  • Most scans show a normally developing baby, which is reassuring.

  • If a concern is found, you have time to prepare, arrange for specialized care, or plan the birth locationaccordingly.

Limitations of the 20-Week Scan

  • Not all abnormalities can be detected.

  • Sometimes, uncertainties arise when the image is unclear, which may lead to additional testing.

  • In rare cases, a serious condition is discovered, which may involve difficult decisions.

Cost and Insurance Coverage

  • The 20-week scan is covered by the Dutch basic health insurance.

  • Follow-up testing in a hospital is also covered, but may count toward your deductible.
    ➤ We advise checking with your insurance provider for details on coverage and out-of-pocket costs.