Between January 1982 and January 1988, 2,060 pregnant patients were scanned for congenital heart defects (CHD). In 76.5% of these patients, there was an increased risk of CHDs in their offspring. In this group there were 27 CHDs, 17 of which were correctly diagnosed prenatally. In the remaining 23.5% of the patients, the indication for cardiac studies was fetal pathology in the present pregnancy (fetal cardiac arrhythmia, polyhydramnios, severe intrauterine growth retardation, fetal ascites and suspected structural anomalies). In this group there were 82 CHDs, 79 of which were correctly diagnosed prenatally. The incidence of abnormal karyotype was 35%. When a CHD is diagnosed, a realistic prognosis can be given and appropriate obstetric measures taken according to the degree of disease. In cases with a good prognosis careful follow-up may be offered resulting in the delivery of an infant in optimal condition. Reassurance can be given to patients when abnormalities are excluded.