What Happens at Your 24-Week Pregnancy Appointment

What your 24-week appointment covers

Your 24-week appointment is one of the most detailed check-ins of your pregnancy. At this visit, your provider will measure your belly, check your blood pressure and urine, listen to the baby's heartbeat, and perform an ultrasound to look at the baby's anatomy, growth, and position. This is also when most providers screen for gestational diabetes using a glucose tolerance test.

The appointment typically lasts 30 to 45 minutes, though ultrasounds can add time. You'll see your regular OB, midwife, or family medicine doctor, and may also see a sonographer if the ultrasound is done in-house. Some practices send you to a separate imaging center for the detailed anatomy scan, which means a second appointment that same week.

Key Takeaways

• The 24-week ultrasound checks the baby's organs, spine, heart, brain, and limbs for structural development, and measures the baby to confirm dates.
• You will have a glucose screening test (usually a drink followed by a blood draw one hour later) to check for gestational diabetes.
• Your provider will discuss the results of any earlier tests, including your anatomy scan findings and any follow-up imaging if needed.
• This is the right time to ask about labor options, pain management, and what to expect in the third trimester.

The anatomy ultrasound at 24 weeks

The detailed anatomy scan at 24 weeks is longer and more thorough than earlier ultrasounds. The sonographer will measure the baby's head, femur (thigh bone), and abdomen to confirm your due date and check growth. They will also examine the brain, spine, heart, lungs, stomach, kidneys, and limbs in detail, looking for any structural differences that need monitoring or follow-up.

The scan takes 20 to 30 minutes. You'll lie on your back while the sonographer moves the ultrasound wand across your belly. The baby's position matters — if the baby is facing away from the probe or curled up, the sonographer may ask you to walk around or change position to get better views. Some babies cooperate immediately; others do not. If the sonographer cannot see everything clearly, you may be asked to return for a follow-up scan in a week or two.

You will receive images and a written report. Your provider will review the findings with you at your appointment or by phone if the scan is done elsewhere. Most findings are reassuring. If the sonographer notes anything that needs closer look or specialist review, your provider will explain what it means and what happens next — which is often just another ultrasound in a few weeks to watch how things develop.

Glucose screening and gestational diabetes testing

Between 24 and 28 weeks, most providers order a glucose screening test to check for gestational diabetes. This is usually done at your 24-week visit. The test involves drinking a sweet liquid (typically 50 grams of glucose) and having your blood drawn one hour later. You do not need to fast beforehand, and you can eat and drink normally that day.

The drink tastes like flat soda or syrup and takes a few minutes to finish. Some people find it easy; others find it too sweet. You will sit in the waiting area for the hour, then have blood drawn. Results usually come back within a few days. A normal result means you do not have gestational diabetes. If your result is higher than the threshold your provider uses, you will be asked to return for a longer, three-hour glucose tolerance test to confirm whether gestational diabetes is present.

Gestational diabetes is common — it develops in about 2 to 10 percent of pregnancies depending on risk factors and how the test is interpreted. If you have it, your provider will discuss diet, activity, and possibly insulin or medication. It does not mean you did anything wrong, and it usually goes away after delivery. Your baby will be monitored more closely in the third trimester and after birth.

Blood pressure, weight, and urine checks

At every prenatal visit, your provider checks your blood pressure, weighs you, and tests your urine. At 24 weeks, these measurements help track how your body is handling pregnancy and catch any early signs of complications like preeclampsia or urinary tract infection.

Weight gain varies widely and depends on your starting weight, how many babies you are carrying, and your individual metabolism. Your provider is looking at the pattern over time, not a single number. If your blood pressure is higher than your baseline or your urine shows protein or glucose, your provider will discuss what that means and whether any follow-up is needed.

Fetal heart rate and position

Your provider will use a handheld Doppler device to listen to the baby's heartbeat. At 24 weeks, the normal fetal heart rate is 120 to 160 beats per minute. Hearing the heartbeat is reassuring and often a highlight of the visit for parents. Your provider will also feel your belly to get a sense of the baby's size and position — whether the baby is head-down, breech, or transverse (sideways).

At 24 weeks, the baby still has room to move and change position, so breech or transverse position is not a concern yet. Your provider will check position again at later visits. If the baby is breech at 36 weeks or later, your provider will discuss options like external cephalic version (a procedure to turn the baby) or planned cesarean delivery.

What to bring and how to prepare

Bring your insurance card, photo ID, and any paperwork your provider's office sent you. Wear comfortable, loose clothing that allows easy access to your belly for the ultrasound and physical exam. Eat a normal meal before your appointment — you do not need to fast for the glucose screening, and having food in your stomach can help you feel less lightheaded after the sweet drink.

If you have questions about labor, pain management, birth plans, or what to expect in the third trimester, write them down beforehand. The 24-week visit is a good time to discuss these topics because you are past the early pregnancy stage but still have time to plan. If your provider does not bring up these topics, ask. Some practices also discuss cord blood banking, newborn screening, and infant feeding at this visit.

What happens if something is found on the ultrasound

Most 24-week ultrasounds show a healthy, normally developing baby. If the sonographer or your provider finds something unexpected — such as a heart defect, kidney difference, or growth concern — your provider will explain what was seen, what it means, and what the next steps are.

Next steps might include a follow-up ultrasound in a few weeks, a referral to a maternal-fetal medicine specialist for a second opinion, or fetal echocardiography (a detailed heart ultrasound). Your provider will also discuss how the finding might affect your pregnancy, labor, and delivery, and what to expect after the baby is born. Many findings that look concerning on ultrasound turn out to be minor or resolve on their own. Others require planning and specialist care. Your provider is there to help you understand and prepare.

Frequently Asked Questions

Can my partner or family come to the 24-week appointment?

Yes. Most providers welcome a partner or support person at prenatal visits, and many parents want their partner present for the ultrasound. Call your provider's office ahead if you plan to bring someone, especially if space is limited or if your practice has visitor policies.

What if I fail the glucose screening?

A higher result on the one-hour screening does not mean you have gestational diabetes — it means you need a longer test to confirm. About 15 to 25 percent of people have a higher screening result, but only about one-third of those actually have gestational diabetes. Your provider will schedule a three-hour glucose tolerance test, which involves fasting and four blood draws.

Is the ultrasound safe to do at 24 weeks?

Yes. Ultrasound uses sound waves, not radiation, and has been used safely in pregnancy for decades. The 24-week anatomy scan is one of the most important ultrasounds because it allows detailed look at the baby's development and can catch structural differences early.

What if the baby is breech at 24 weeks?

Breech position at 24 weeks is normal and not a concern. Babies move and change position throughout pregnancy. Your provider will check position again at later visits. If the baby is still breech at 36 weeks or later, your provider will discuss options like trying to turn the baby or planning a cesarean delivery.

Can I see the baby's face on the 24-week ultrasound?

Sometimes, depending on the baby's position and the quality of the ultrasound machine. The focus at 24 weeks is on measuring and checking organs rather than getting a clear face photo, but if the baby is positioned well, you may get a profile or front view. Ask the sonographer if they can get a face image — many will try if time allows.