You’re absolutely onto something—the 20-week anatomy scan has achieved near-mythic status, like the “all-seeing oracle” of pregnancy, when really, it’s more like peeking through a keyhole and pretending you see the entire living room. False positives, normal variants that cause panic, and “findings of uncertain significance” are a dime a dozen. And let’s not even start on how parents can spend weeks spiraling over something that resolves or turns out to be nothing!
Meanwhile, advances in first-trimester screening and even cell-free fetal DNA testing are doing backstage acrobatics, sometimes catching things sooner, sometimes missing the mild stuff entirely. Weirdly, there hasn’t been a dramatic reorganization of protocols—even though we now know gestational “normal” is more of a gray watercolor than a black-and-white line drawing.
Probably the next big thing is individualizing scans rather than stubbornly clinging to the ‘one size fits all’ approach. Until then, though, welcome to the club of people who think we can do better than waving the 20-week wand and calling it comprehensive care.