Placenta Accreta and C-section

Dear Ask The Doctor: Hello, I had a c-section for the birth of my first child and presented placenta accreta. My doctor has told me that for a second pregnancy it might happen again, so I should probably have a c-section. What are the possibilities? I was hoping for a water birth on my next pregnancy. My mother had placenta accreta as well and now my identical twin sister is pregnant. Is it hereditary? Would she have it as well? Kind regards, Carolina

Dear Carolina: Major risk factors for placenta accreta include previous cesarean scar, multiple gestation and placenta previa - placenta is placed in the lower half of the uterus overlying the cervical opening to various extent. In your case, the possibility of placenta accreta recurrence is high due to the presence of previous cesarean scar. This condition has not been studied to have any hereditary links, your sister may not have a similar condition.