Complex obstetric surgery means all types of operations during pregnancy regarding the conditions that could be a risk for maternal and fetal morbidity. It includes all kind of services Women suffering from pregnancy related problems are increasing. Recognition of such patients reduces the risk of morbidity and mortality. The term Complex Obstetric Surgery (COS) implies that all operations carry more than the typical risk for maternal and fetal morbidity. It was established to regionalize patient care, and improve preoperative assessment, to reduce surgical morbidity. The COS program deals with patients at high risk for intrapartum and postpartum complications such as: