Objectives: To identify factors predictive of obstetric uterine rupture after operative hysteroscopy. When these factors are present, to know if there are means to prevent subsequent uterine rupture. Finally, to specify the criteria for extracting the fetus before rupture. Patients and methods: Description of a case of uterine rupture in a patient with a history of uterine septum rupture treated by operative hysteroscopy and retrospective analysis of the 12 similar observations reported in the literature. Results: Two types of situations are to be differentiated: uncomplicated hysteroscopic ablation of a polyp or submucosal myoma, which does not seem to modify the obstetrical prognosis; metroplasties for uterine malformation, resections of complex synechia, uterine perforations secondary to resection with the use of a monopole section current, constituting situations at high risk of obstetrical rupture. Conclusion: Uterine ruptures secondary to operative hysteroscopy are rare but serious. They may occur before any labour, and involve the vital prognosis of the mother-foetus. Once the risk factors have been identified, there is no way of preventing the progression to obstetric uterine rupture. The vigilance of the obstetrician in this context must be extreme, trying to authenticate the slightest clinical sign in favour of a pre-rupture of the uterus. However, systematic Caesarean section is not justified.