Anomaly Scan (Level 2 / TIFFA) in Delhi
The detailed 18–20 week survey of the baby's anatomy, organ system by organ system.
What anomaly scan involves
The anomaly scan — also called a Level 2 scan or TIFFA — is the most thorough examination of fetal structure in the whole pregnancy. It works systematically through the brain, face, spine, heart, lungs, diaphragm, abdominal wall, stomach, kidneys, bladder, limbs, hands and feet, and checks the placenta, cord and amniotic fluid.
It takes thirty to forty-five minutes when done properly, and it is worth insisting on that time. The detection rate varies considerably by organ system — very high for major brain, spine and abdominal wall defects, lower for cardiac and skeletal conditions — and being told that honestly beforehand makes a normal result easier to interpret.
Who this is for
- All pregnancies, between 18 and 20 weeks
- Raised risk on first-trimester screening
- Diabetes, epilepsy medication or other exposures in early pregnancy
- Previous baby with a structural anomaly, or a family history of one
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
Systematic survey
Every organ system examined in a fixed sequence so nothing is skipped.
Biometry
Head circumference, abdominal circumference and femur length, plotted against gestation.
Placenta, cord and fluid
Placental position and appearance, cord vessels, and amniotic fluid volume.
Cervical length
Measured in the same sitting, because a short cervix at 20 weeks is the best predictor of preterm birth we have.
Your results, in writing
Whatever the outcome of anomaly scan, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: A short cervix found because someone measured it
30, Mayur Vihar · anomaly scan at 19 weeks · no risk factors
What she came in with
A routine anomaly scan in a first pregnancy with no history of preterm birth, no symptoms and nothing to suggest a problem.
What the workup showed
The fetal anatomy survey was entirely normal. Cervical length, measured as part of the same appointment, was 19 mm — well below the 25 mm threshold and a strong predictor of preterm delivery. Many anomaly scans do not include this measurement at all.
What we did
Vaginal progesterone 200 mg nightly started immediately, with cervical length rechecked fortnightly. At 21 weeks it had shortened further to 15 mm with funnelling, and a cervical cerclage was placed.
Outcome
The cervix remained stable thereafter. The stitch was removed at 37 weeks and she delivered at 38+4 — a term baby in a pregnancy that was heading for a delivery around 26 weeks.
The point of this case
There was nothing in her history to suggest she was at risk. The only reason this was found is that the cervix was measured at a scan where it often is not.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
A full 30–45 minute appointment, not a ten-minute run-through
Cervical length included as standard
Findings explained during the scan and in a same-day written report
Fetal medicine referral arranged immediately where anything needs a second opinion
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
- Anomaly Scan in Katwaria Sarai
- Anomaly Scan in Greater Kailash
- Anomaly Scan in Hauz Khas
- Anomaly Scan in Munirka
- Anomaly Scan in Ber Sarai
- Anomaly Scan in Safdarjung Enclave
- Anomaly Scan in Vasant Kunj
- Anomaly Scan in Vasant Vihar
- Anomaly Scan in R.K. Puram
- Anomaly Scan in Green Park
- Anomaly Scan in Malviya Nagar
- Anomaly Scan in Saket
- Anomaly Scan in Chittaranjan Park
- Anomaly Scan in Kalkaji
- Anomaly Scan in East of Kailash
- Anomaly Scan in Nehru Place
- Anomaly Scan in Lajpat Nagar
- Anomaly Scan in Kailash Colony
- Anomaly Scan in Defence Colony
- Anomaly Scan in Alaknanda
Questions about anomaly scan
What is the detection rate of an anomaly scan?
Roughly 70–80% of major structural anomalies overall, but it varies sharply: over 95% for anencephaly and major spine defects, around 50–60% for congenital heart disease, and lower still for some skeletal and gut conditions. A normal scan is very reassuring but is not a guarantee of a normal baby.
Why is the cervix measured at this scan?
Because a cervical length under 25 mm at 18–24 weeks is the strongest single predictor of preterm birth, and it is treatable with vaginal progesterone or a cervical stitch. Many centres skip it. We do not.
Can you tell me the baby's sex at this scan?
No. Prenatal sex determination is a criminal offence in India under the PC-PNDT Act. We do not disclose it under any circumstances, and the request should not be made.
What happens if something is found?
Most findings are minor variants that need nothing more than a follow-up scan. Where something significant is seen, we explain it, arrange a fetal medicine opinion and fetal echocardiography where relevant, and go through the options with you properly rather than in a corridor.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.