Poor vascularization and tissue oxygenation in the area of a Cesarean scar is associated with local failure of re-epithelialization and decidualization, which has an impact on both implantation and placentation, as well as a possible effect on placental development and, subsequently, fetal growth. Furthermore, recent studies have suggested that pregnancies complicated by placenta previa are at higher risk of delivering a small-for-gestational-age (SGA) neonate and are associated with a higher incidence of placental vascular supply lesions. Several authors have found that spiral artery remodeling is reduced in PAS. Incomplete transformation of the spiral arteries and lesions associated with maternal vascular malperfusion are commonly found in placenta-related disorders of pregnancy, such as FGR and pre-eclampsia, suggesting that PAS placentation in a pregnancy complicated by placenta previa may have an even greater impact on placental development and function. Placenta previa and PAS disorder are both associated with high risks of prenatal and perinatal maternal complications but there are limited data available on their possible impact on fetal growth.