The origin of a de novo metacentric small marker chromosome found in a cytogenetic study in amniotic fluid was determined by fluorescence in situ hybridization (FISH) using chromosome specific probes. It was identified as an isochromosome 18p. We want to emphasize that when an extra chromosome is found in prenatal diagnosis and it cannot be identified by conventional cytogenetics banding, FISH should be applied in order to give real risks for fetal anomalies and an accurate genetic counselling.