The value of echogenic fetal intracardiac structures (golf ball phenomenon) as predictors of chromosomal anomalies.

Small echogenic areas in the fetal heart are known as the golf ball phenome non. These structures are considered by some to be a marker for chromosomal anomalies. Aim: To prospectively study the relationship of echogenic intra cardiac structures and chromosomal aberrations. Methods: Over a 15 month pe riod (6/96-9/97) 4500 unselected fetuses between 16-31 weeks were screened for malformations; in each case echogenic intracardiac structures were soug ht. Results: In 77 cases (1,17 %) single or multiple echogenic punctate int racardiac structures could be diagnosed. In 60 fetuses (78%) chromosome ana lysis was performed. Two (3,3 %) had chromosomal abnormalities-trisomy 21 a nd 45,XO/46,XX. Conclusion: The golf ball phenomenon appears to be a normal variation in the development of the papillary muscle. This sign is usually easily to identify and if present, should lead to a more detailed screenin g for anomalies. In the case of other sonographic abnormalities, with advan ced maternal age or with a positive triple test, a chromosomal analysis sho uld be performed.