Etuk SJ, et al. - Via this secondary analysis of a nationwide cross-sectional study of women admitted for pregnancy, childbirth or puerperal complications at 42 Nigerian tertiary hospitals, researchers examined the burden of maternal near-miss and death due to rupture of the gravid uterus. In addition, they sought for the indicators of quality of care, and avoidable factors associated with care deficiencies for ruptured uterus in these tertiary hospitals. During the study period, 91,724 live births were identified. Severe maternal outcome [SMO: maternal near-miss (MNM) or maternal death (MD)] was reported in 3285 women; 392 women had SMO due to uterine rupture: 305 MNM and 87 MD. Findings revealed SMO was significantly attributable to uterine rupture in Nigerian tertiary hospitals. They recommend addressing avoidable institutional factors and including community-based interventions in strategies to improve maternal survival, in order to encourage skilled attendance at birth and early referral of complications.