Twin-fetus transfusion syndrome at 31 weeks is mainly treated surgically, including fetoscopic laser electrocoagulation, continuous amniotic fluid reduction, and amniotic longitudinal opening; pharmacologic therapy is currently used sparingly in the clinic. Twin fetal transfusion syndrome is a serious complication caused by twin amniotic sacs and single chorionic villus of monozygotic twin fetuses, in which the blood volume of the donor child decreases continuously, and oligohydramnios and amniotic fluid are present, while the opposite is true for the recipient child. 1. Pharmacological treatment: the commonly used drugs in the past are digoxin and indomethacin, the mechanism is to reduce the amount of amniotic fluid by decreasing the renal blood flow, so that the production of fetal urine decreases. However, long-term use of these drugs leads to stenosis of the fetal arterial ducts, which may aggravate the symptom in blood-supplying fetuses that already have low urine output. 2. Surgical treatment: (1) Fetoscopic laser electrocoagulation: i.e., the transportation branches of placental blood vessels are made to coagulate by laser, thus playing a therapeutic role. (2) Continuous amniotic fluid reduction: the amniotic cavity of the recipient child with excessive amniotic fluid is punctured and drained to reduce premature rupture of membranes, prolong the pregnancy, and improve the healing of the twin-transfusion syndrome. (3) Longitudinal amniotic septostomy: open window surgery can make the amniotic fluid in the amniotic cavity of the recipient child flow into the amniotic cavity of the donor child to reduce the pressure of the recipient child and increase the amniotic fluid volume of the donor child in order to improve the circulatory volume of the donor child, but it is used less often. (4) Amniostomy: Amniostomy is firstly required to deal with the disease under ultrasound, using a piercing needle to puncture the diaphragm between the two fetuses, so that the flow of amniotic fluid in the two amniotic sacs can be balanced, and compared with amniotic fluid reduction, only one operation is required, but the efficacy of this procedure is poor.