In patients with a prior cesarean delivery, some propose the risk of placenta accreta spectrum (PAS) is influenced by uterine factors such as cesarean scar defect size, remaining myometrial scar thickness, and defective decidua.1,2 We sought to evaluate PAS risk factors associated with prior surgical procedures and wound healing to optimize triage and counseling in pregnancies at the highest risk for PAS, specifically in patients with placenta previa and prior cesarean delivery.