Golf Ball Syndrome

On about 20th week of pregnancy, it is common to have a mid-pregnancy scan. During this procedure, ultrasound will reveal how baby’s organs(including heart), are developing. During the examination process, sonographer, (doctor performing the scan) may notice small bright spots on the baby’s heart. Because of their visual appearance, these white spots are referred to as gold balls and we would normally say that baby has a gold ball syndrome. Medical term for the spots is echogenic foci/focus.


Golf balls are found in up to 5% of fetuses. Their amount could vary from one to higher and are commonly located in the left ventricle of the heart. Usually their presence is not considered to be threatening : normally, they indicate neither fetal  heart defect nor a heart dysfunction. Medically the process is explained as the mineralisation within a papillary muscle.  


However, in some rare cases golf ball syndrome could be related to heart defect too. Additionally there has been identified a bond between golf balls and chromosomal abnormality, trisomy, causing the down syndrome. The suspicion about golf ball syndrome resulting in trisomy usually raises when mother has other medical problems and further fetal problems have been identified during the ultrasound.


Absence of other risk factors such as no medical issues and young maternal age, decrease the chance of a down syndrome significantly.


It is usually advised to perform an additional scan in about 3 weeks. First of all, because the golf ball syndrome has the tendency to disappear itself. If not, the detailed scan will reveal if there are any additional defects or whether the amniocentesis needs to be performed.  When there is an uncertainty about harmlessness of golf balls, followed by certain pregnancy complications and risks, amniocentesis is a definite way to figure everything out.


During pregnancy, baby is surrounded by the sac of fluid, which is called amniotic fluid. Baby’s skin cells are shedded in the fluid and examination of this cells gives the opportunity to identify whether the baby has correct number of chromosomes. This medical procedure is called amniocentesis or chorionic villus sampling and is performed via passing a relatively thin needle through mother’s abdomen into the amniotic fluid. Amniocentesis is a very accurate representation of baby’s chromosome number and accordingly, gives a trustful impression whether baby could have a down syndrome.


Amniocentesis is not always recommended to perform and healthcare providers will only advise making the procedure when they have a reasonable suspicion about chromosomal abnormality.


Complications following the procedure could include bleeding, leakage of amniotic fluid, miscarriage or severe cramping. The complications are not common, however are worth to be taken into consideration.
In case of a surrogacy pregnancy, agency and clinics should simultaneously organize further scans in coordination with intended parents.  Parents, on other hand, may like to be informed in advance about how much is the agency prepared for such occurrences and which procedures do they use to identify baby’s condition as clearly as possible.