Down’s syndrome screening mainly screens for fetal chromosomal abnormalities and fetal neural tube defects. If there is a high risk of open neural tube defects, it indicates that the fetus may have some neural tube defects, such as fetal spina bifida, fetal anencephaly, and fetal basilar bulge, which are all manifestations of abnormal development of the fetal central nervous system. In case of open neural tube defects with high risk in Down’s syndrome screening, it does not necessarily mean that the fetus has developmental abnormalities. Further imaging tests as well as non-invasive DNA and amniocentesis are recommended to confirm the diagnosis. In case of this neurological developmental abnormality, it is recommended to terminate the pregnancy. If there is no abnormality, the pregnancy can be continued and the labor and delivery can be continued to observe the development of the fetus. Therefore, a high risk of open neural tube defects in Down screening requires mainly observation of the fetal ultrasound.