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What is Level 2 Ultrasound? 

Level 2 ultrasound, also known as high-resolution ultrasound, targeted ultrasound, foetal anatomical survey or comprehensive ultrasound, is similar to a standard ultrasound imaging technique that employs high-frequency sound waves to produce an image of the baby and other surrounding internal structures. However, level 2 ultrasound provides more detailed information as compared to standard ultrasound. Also, the staff employed to perform a level 2 ultrasound test and interpret the results are comparatively more qualified than those involved in standard ultrasound imaging. 

Unlike standard ultrasound, which is generally recommended during the first trimester of pregnancy, level 2 ultrasound is recommended specifically during the second trimester, ie, 18 to 20 weeks of pregnancy.

  1. Why is Level 2 Ultrasound performed during pregnancy?
  2. How do you prepare for Level 2 Ultrasound?
  3. How is Level 2 Ultrasound performed during pregnancy?
  4. What do Level 2 Ultrasound results indicate?
  5. How much does a Level 2 Ultrasound cost?

Level 2 ultrasound testing is individualised based on the risk factors of the mother and baby. This test is mainly recommended to pregnant mothers whose babies are suspected of having birth defect based on the results of a standard ultrasound. Level 2 ultrasound helps detect foetal anomalies and other details related to foetal growth and development, which are not visible in standard ultrasound.

Additional details of the foetus that can be identified with this scan are: 

  • Organ structure, eg brain 
  • Gender of the baby
  • Umbilical cord 
  • Level of amniotic fluid (a clear yellow fluid present in the sac in which the foetus is protected inside the womb)
  • Foetal heart rate 
  • Size of the baby 
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No special preparation is needed for this test. The doctor may ask you to drink plenty of water so your bladder is full before the test and the images produced are more clear. You will be allowed to empty your bladder only after completing the test. Also, you may be asked to wear a gown.

Level 2 ultrasound can be performed in two ways:

  • Abdominal level 2 ultrasound: It involves gliding the transducer probe on the abdominal area after application of a gel on the abdomen.
  • Transvaginal level 2 ultrasound: It involves the insertion of a transducer probe in the vagina to take a picture.

Neither of these tests risk or harm the mother or the baby. However, special care is needed to avoid prolonged and frequent exposure of the foetus to sound waves. Also, the long-term effects of this test are not known, it may pose a risk to the foetus.

Normal results: Absence of any abnormality in the foetus and its surrounding structures, and an appropriate size of the baby for the gestational age in which the test is performed, is considered a normal result. This test also detects the presence of multiple pregnancies. Although multiple pregnancies are normal, they need special care as they involve a higher risk of complications. Depending on various factors, normal results may vary slightly, a doctor can help with correct interpretation of results.

Abnormal results: These include

  • Structural abnormalities of foetus
  • Congenital malformations, ie abnormalities present at birth
  • Developmental issues
  • Confirmation of intrauterine death of foetus, ie, death of the baby in mother’s womb
  • Higher or lower levels of amniotic fluid
  • Abnormal growth
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The cost of level 2 ultrasound ranges between 1000 to 3650 INR. However, the price of this test may vary based on the city and the laboratory in which the test is conducted. 

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.  



  1. Stanford Children's Health: Lucile Packard Children's Hospital, Stanford; Ultrasound in Pregnancy
  2. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Specialized Imaging: Fetal Level II Ultrasound
  3. Emory University School of Medicine [internet]. Department of Human Genetics. Division of Medical Genetics; Sonography or Ultrasound
  4. Cleveland Clinic. [Internet]. Cleveland, Ohio. Pregnancy: Prenatal Ultrasonography: Test Details
  5. American Pregnancy Association [internet]; Ultrasound: Sonogram
  6. US Food and Drug Administration (FDA) [internet]; Ultrasound Imaging
  7. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Complications of Multiple Pregnancy
  8. Lazarus E a Levine D. The first trimester. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018: chap 30.
  9. Richards DS. Obstetric ultrasound: imaging, dating, growth, and anomaly. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 9.
  10. Wapner RJ. Prenatal diagnosis of congenital disorders. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014: chap 30.
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