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The aim of this study was to explore the application of standardized ultrasonography in the first trimester. A total of 1670 pregnant women who underwent ultrasonography in the first trimester (1706 fetuses) and 2,562 pregnant women who underwent ultrasonography in the second trimester (2637 fetuses) visiting the Second Affiliated Hospital of Nanchang University from January 2016 to December 2018 were included in this prospective study. Standardized ultrasonography was performed on the fetuses and pregnancy outcomes were tracked in abnormal cases. A total of 20 cases of fetal structural abnormalities were detected in the first trimester and the number of pregnant women who chose to induce labor was as high as 15. A total of 41 cases of fetal soft marker abnormalities were detected in the first trimester and most of these markers returned to normal. A total of 113 cases of malformed fetuses were detected in the second trimester. Additionally, those cases that did not undergo standardized ultrasonography in the first trimester were significantly more likely to show fetal abnormalities in the second trimester than those who had standardized ultrasonography in the first trimester. Some fetal malformations, especially some severe ones, can be detected by standardized ultrasonography in the first trimester. However, standardized ultrasonography in the second trimester which was regard as the best period for fetal malformation detection cannot be replaced by the first trimester. It is better to conduct standardized ultrasonography in both first and second trimesters.