Data of Korea National Statistical Office is showing that the birth rate in Korea is decreasing but high risk pregnancy is increasing; the old age mother, prematurity and low birth weight newborns and multiple twins are increasing. These facts are requiring the Korean government to establish an integrated perinatal management system “High-Risk Maternal and Newborn Centers (HMNC)”. However, the reality is reduction of number of obstetrician, neonatal physician and their related physicians. The lack of beds for the neonatal intensive care unit (NICU) and bed for pregnancy are other problems to be solved by Korean government. More than 20% of all neonatal deaths were related to neonatal surgical diseases. The understanding of perinatal surgical disease and its professional surgical care are necessary to eliminate the maternal anxiety, maintain the pregnancy and improve the treatment outcomes of HMNC. Thus, it is ideal that HMNC would have board certified pediatric surgeon. At the same time, HMNC should have surgical facilities and personnel who support the pediatric surgeon's activity. If HNMC could not hire full time surgical specialist due to any reasons, it should have legal medical system to support pediatric surgeons to help the newborn with surgical diseases in HN