What to Expect at Your 7-Week Ultrasound Appointment

There’s nothing quite as satisfying as seeing your fast-growing baby—and the flicker of their little heartbeat—on an ultrasound scan. If you just got your positive pregnancy test (Congrats!), you might be wondering if you need an ultrasound around 7 weeks.

The American College of Obstetricians and Gynecologists (ACOG) officially recommends at least one ultrasound during pregnancy—the mid-pregnancy ultrasound at 18 to 22 weeks—unless you’re at risk for certain complications. But in practice, many providers offer more than one ultrasound—including one in the first trimester.

“I had an ultrasound at 7 weeks because I had just found out I was pregnant and made my first prenatal appointment as fast as possible since I was so excited,” shares Natalie Gontcharova, senior editor at The Bump and mom of one.

Here, learn why your provider might order a 7-week ultrasound and what to expect.

Will You Get an Ultrasound at 7 Weeks?

It’s relatively uncommon to get an ultrasound at 7 weeks, says Catherine Caponero, DO, an ob-gyn at Cleveland Clinic. Some practitioners, however, do perform a first-trimester ultrasound starting at 7 weeks of pregnancy, since that’s when a heartbeat should be visible, to confirm viability and estimate your due date—particularly if you aren’t sure of the date of your last menstrual period or have irregular periods, or if you had complications in a previous pregnancy.

First trimester scans can also be helpful in determining genetic abnormalities. However, most of the time these scans are performed later. “Most of our first trimester scans are done between 11 to 13.6 weeks, for the nuchal translucency,” says Kimberly Khabeer, a sonographer at Temple University Hospital in Philadelphia.

Why You Might Get a 7-Week Ultrasound

You might get a 7-week ultrasound to confirm the embryo is located inside the uterus and has a heartbeat. Your doctor may also want to monitor for potential problems, including to check for an ectopic pregnancy (when the embryo implants outside of the uterus), evaluate vaginal bleeding, figure out the cause for pelvic pain, diagnose multiple gestations or locate or remove an intrauterine device (IUD), says Caponero.

What Happens at the 7-Week Ultrasound?

During a 7-week ultrasound, your practitioner may attempt a transabdominal ultrasound, where the wand is placed on your lower abdomen. If they can’t see what they need to see, they’ll give you a transvaginal ultrasound, where the wand is placed inside the vagina.

Your healthcare provider will examine your uterus, cervix and the area around the ovaries and fallopian tubes, to make sure everything looks as expected. They’ll check for the location of a gestational sac (a fluid-filled structure surrounding the embryo) and yolk sac (which nourishes the pregnancy until the placenta takes over at around 12 weeks). They’ll also measure the crown-to-rump (head-to-butt) length of the embryo and check cardiac activity.

You don’t necessarily need to prepare for this appointment. But if your doctor wants to attempt a transabdominal ultrasound, they may ask that you come to your appointment with a full bladder, which makes it easier to see things.

What Can You See at the 7-Week Ultrasound?

At 7 weeks pregnant, baby’s the size of a blueberry. An ultrasound will usually show a gestational sac, yolk sac and a small embryo. “It might resemble a grain of rice with flickering of the cardiac cords,” says Khabeer.

Can twins be detected at a 7-week ultrasound?

While twins can be detected at a 7-week ultrasound, they can be missed depending on where the pregnancy is located in the uterus, the type of twins or even your anatomy, says Caponero.

What if you see nothing at the 7-week ultrasound?

It’s possible that you won’t see a gestational sac or an embryo at your 7-week ultrasound even though you’re pregnant. That’s because it can be challenging to accurately date a pregnancy early on.

That said, at 7 weeks, your provider can diagnose a miscarriage “if the gestational sac is too big and an embryo isn’t seen, or if the embryo doesn’t have a heartbeat and is at least 7 millimeters long,” says Caponero. They also may suspect an ectopic pregnancy if they don’t see a gestational sac inside of the uterus. If that happens, your practitioner will check around the uterus for any abnormalities to figure out the best next steps.

7-week Ultrasound Pictures

If you get an ultrasound at 7 weeks, your provider or technician will let you get a sneak peek of the screen and print out a blurry photo for you. You might not be able to tell what’s what, but it might look something like this:

Next Steps After the 7-Week Ultrasound

After a 7-week ultrasound, next steps depend on what your practitioner observes. If they only see a gestational sac inside the uterus, the dating of your pregnancy may have been off. Your doctor will often recommend waiting two weeks before repeating an ultrasound, at which point they should be able to see an embryo with a heartbeat. “While it can be very hard to wait, it’s so important for expectant parents to have a clear answer instead of uncertain possibilities,” says Caponero. If your practitioner doesn’t see a gestational sac in your uterus, they may order bloodwork to determine the best timing for additional imaging, testing or treatment, Caponero says.

To Sum It Up

While it’s not super common, some practitioners perform an ultrasound starting at around 7 weeks to date the pregnancy and check for a heartbeat. Otherwise, a 7-week ultrasound is usually only recommended if your doctor wants to check out potential complications like pain and bleeding.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.