The Level II / Targeted Anomaly Scan, also known as TIFFA (Targeted Imaging for Fetal Anomalies), is the most comprehensive ultrasound examination performed during pregnancy. Typically carried out between 18 and 22 weeks, it evaluates the fetal anatomy in meticulous detail – surveying the brain, face, spine, heart, chest, abdomen, limbs, and placenta.
This scan is the cornerstone of structural screening, designed to detect over 90% of major congenital anomalies when performed by an experienced specialist. It provides reassurance for most families and, when an anomaly is identified, allows for informed decision‑making, early planning, and coordination with paediatric and surgical teams.
At Amytri, our Level II scan is performed by a consultant radiologist with advanced training in fetal medicine. Using state‑of‑the‑art high‑resolution ultrasound, we follow a strict protocol to examine every fetal structure. We explain our findings in real time, provide a detailed written report, and, if any concerns arise, discuss the next steps – including further imaging, genetic testing, or multidisciplinary consultation.
The Level II scan is the gold standard for structural assessment – it provides the most comprehensive look at your baby's development and is essential for detecting many treatable conditions.
When performed by an experienced fetal medicine specialist, the Level II scan detects the vast majority of major congenital anomalies – including heart defects, neural tube defects, and abdominal wall defects.
If a condition is identified, the scan allows for early coordination with paediatric specialists, surgical teams, and neonatal intensive care – ensuring your baby receives the best possible care from the moment of birth.
For most women, the Level II scan shows a normally developing baby with no anomalies – providing profound reassurance for the remainder of the pregnancy.
Our Level II scan follows a comprehensive protocol that includes all of the following – and more if clinically indicated.
We examine the brain hemispheres, ventricles, cerebellum, cisterna magna, and the midline falx – looking for ventriculomegaly, spina bifida, holoprosencephaly, and other anomalies.
We perform a detailed fetal echocardiogram – assessing the four chambers, outflow tracts, aortic arch, and ductus arteriosus – to detect congenital heart defects, which are among the most common anomalies.
We evaluate the lungs, the position of the heart, and the diaphragm – looking for congenital diaphragmatic hernia, pleural effusions, or lung masses.
We check the stomach, liver, bowel, and abdominal wall – for gastroschisis, omphalocele, duodenal atresia, and other anomalies.
We assess the kidneys, ureters, bladder, and external genitalia – for renal agenesis, hydronephrosis, posterior urethral valves, and other conditions.
We examine the spine, ribs, long bones, hands, and feet – screening for skeletal dysplasias, limb deficiencies, and clubfoot.
We evaluate placental location, cord insertion, number of vessels, and amniotic fluid volume – important for diagnosing conditions like placenta previa, vasa previa, and oligohydramnios.
We measure biometric parameters (BPD, HC, AC, FL) to assess growth, and we check for fetal movements and the amount of amniotic fluid to ensure wellbeing.
We recommend booking between 18 and 22 weeks – earlier may not show all structures clearly, and later may limit diagnostic options if an anomaly is found.
We ask you to come with a comfortably full bladder – this improves visualisation of the pelvic organs. Wear loose, two‑piece clothing for easy access.
We systematically examine every anatomical system. The scan takes 45‑60 minutes – we may ask you to change position or walk around if the baby is not cooperating.
We discuss our findings with you in real time, provide a comprehensive written report, and if any anomalies are detected, we explain the implications and coordinate further care – including genetic counseling, fetal echocardiography, or multidisciplinary consultation.
While the Level II scan is offered as a standard part of antenatal care in many settings, it is especially important in these circumstances.
Advanced maternal age is associated with increased risk of both chromosomal and structural anomalies – a Level II scan provides the most detailed assessment.
If first‑trimester screening or NIPT indicates increased risk, the Level II scan is essential to check for structural anomalies that may accompany chromosomal conditions.
If you've had a previous pregnancy with a congenital anomaly, a targeted assessment can provide reassurance and guide surveillance.
Certain maternal conditions are associated with increased risk of fetal anomalies – detailed assessment helps monitor for any effects.
Twins or triplets have a higher incidence of structural anomalies – each baby must be assessed individually, which requires extra time and expertise.
Many families choose the Level II scan for the deepest possible reassurance about their baby's health – it is the standard of care in many countries and is recommended for all pregnancies.
The Level II scan requires advanced training and a meticulous approach. Our consultant radiologist has specialised expertise in fetal medicine and follows rigorous protocols to ensure that every structure is visualised and documented correctly. With extensive experience in obstetric ultrasound, we provide the highest standard of care – from accurate detection to clear, compassionate communication.
The Level II scan is a special milestone – seeing your baby in such detail is an unforgettable experience. We warmly encourage your partner to attend.
The scan room is private, with a large screen for both of you to watch. As we go through each structure, we explain what we are seeing and what it means. If we find anything of concern, we discuss it sensitively and provide a clear plan for next steps – ensuring you both feel supported and informed.
A Level I scan is a basic obstetric ultrasound that typically checks fetal number, presentation, and basic measurements. A Level II scan (TIFFA) is a detailed anatomical survey that examines every major fetal organ and structure, following a strict protocol to detect congenital anomalies. It is performed by a specialist with advanced training in fetal medicine.
Yes, the Level II scan is commonly referred to as the 20‑week anomaly scan, TIFFA, or targeted scan. It is the comprehensive mid‑trimester assessment that all pregnant women are offered in many healthcare systems.
No. While the Level II scan detects the vast majority of major structural anomalies, it cannot detect all birth defects – some conditions (like certain heart defects, metabolic disorders, or subtle brain anomalies) may not be visible. Also, some anomalies develop later in pregnancy and may not be apparent at 20 weeks.
Yes, ultrasound uses sound waves and has no known harmful effects. It has been used safely in pregnancy for decades. The Level II scan takes longer than a basic scan, but it is still completely safe.
We will discuss the findings with you in detail. Depending on the anomaly, we may recommend further tests (e.g., fetal echocardiography, amniocentesis), refer you to a specialist for a second opinion, or arrange a multidisciplinary consultation. Our goal is to provide you with the information and support you need to make informed decisions.
No referral is required – you can book directly. If you are under obstetric care, we will share the report with your doctor.
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