BackgroundGraves’ hyperthyroidism affects 0.2% of pregnant women. Establishing the correct diagnosis and effectively managing Graves’ hyperthyroidism in pregnancy remains a challenge for physicians.MainThe goal of this paper is to review the diagnosis and management of Graves’ hyperthyroidism in pregnancy. The paper will discuss preconception counseling, etiologies of hyperthyroidism, thyroid function testing, pregnancy-related complications, maternal management, including thyroid storm, anti-thyroid drugs and the complications for mother and fetus, fetal and neonatal thyroid function, neonatal management, and maternal post-partum management.ConclusionEstablishing the diagnosis of Graves’ hyperthyroidism early, maintaining euthyroidism, and achieving a serum total T4 in the upper limit of normal throughout pregnancy is key to reducing the risk of maternal, fetal, and newborn complications. The key to a successful pregnancy begins with preconception counseling.

Increasing activity and exercise is essential for health and quality of life for people living with spinal cord injury (SCI). Obesity, cardiovascular disease, and diabetes are 2 to 4 times higher for people with SCI compared to the general population. This is due, in part, to low levels of activity, limited access and opportunities to participate in exercise, as well as changes in muscle and heart function that are common after injury. Exercise is necessary to improve fitness and reduce long-term health complications after SCI. Below are exercise recommendations for improving cardiovascular health, muscular strength and endurance, and flexibility for people with SCI.* These cardiovascular and muscular strength/endurance recommendations are adapted with permission from SCI Action Canada (www. sciactioncanada.ca/guidelines accessed August, 2014).y Moderate intensity: somewhat hard but can be sustained for long periods without experiencing excessive fatigue; Vigorous intensity: very hard, close to maximum and cannot be sustained for long without experiencing excessive fatigue.

There is significant variation in the diagnosis and management of GDM among SMFM members.

The findings demonstrate the potential for some individuals with SCI to safely and effectively engage in aerobic and strengthening exercise in their home to improve or prevent cardiovascular-related risk factors.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A44) for more insights from the authors.

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