The intracardiac echogenic focus by itself has no significance if there is no structural abnormality of the heart reported on fetal echocardiography. When we have seen these echocardiography patients post natally none of them had any abnormaility. Multiple echogenic nodules may be a marker for Down's Syndrome. Therefore it depends on the ultrasonologist to see if there are any extracardiac features suggestive of Down's Syndrome and for the gynaecologist to decide to what extent she wants to investigate to rule out Down's Syndrome.