Pregnancy is accompanied by a lengthy list of do's and don'ts—take prenatal vitamins, no alcohol, exercise carefully, and eat well. But what about when an unplanned health issue presents itself, such as the necessity for a mammogram? For most women, this might not even be something they think about until they are in a position where breast cancer screening is an option.

Perhaps you're over 40 and in need of your yearly mammogram, or perhaps you have a history of breast cancer in your family and you want to keep your screenings current. More emergently, you've found a lump in your breast. So, can you have a mammogram when pregnant? The answer is yes, but there are several things to consider.

Pregnancy creates substantial hormonal changes that affect the body, as well as breast tissue. Estrogen and progesterone's rise causes the breasts to expand and condition to produce milk, which results in denser tissue. This increased density is more challenging to detect any abnormalities with using mammograms. Even post-delivery, should the woman be breastfeeding, milk-filled glands can also make the breasts denser and, as a result, make mammogram readings less clear.

While 3D mammograms have improved imaging technology to help navigate dense breast tissue, doctors often suggest postponing routine screening mammograms until after pregnancy if there are no symptoms or high-risk factors. However, if a lump or abnormality is found, your doctor may recommend immediate diagnostic imaging.

When Is a Mammogram Necessary During Pregnancy?

Mammograms are not done routinely if a woman becomes pregnant, yet there are specific situations where one might be unavoidable. Breast cancer in pregnancy does occur—1 in 3,000 times—but it's not common. If a lump is detected by a woman, she has constant breast pain and no explanation, or she is at high risk (e.g., strong history of breast cancer in her family or genetic defect such as BRCA1 or BRCA2), a physician will order a mammogram.

The process itself takes very little radiation exposure. The radiation employed by a mammogram is concentrated on the breast, and there is little to no radiation that reaches other areas of the body. A lead apron is also placed over the belly to shield the unborn child.

Alternative Breast Imaging Options During Pregnancy

For pregnant women requiring breast imaging, physicians may initially suggest an ultrasound. In contrast to a mammogram, an ultrasound is not done with the use of radiation and is deemed safe for pregnant women.

An ultrasound of the breast can establish whether a lump is a fluid-filled cyst or a solid tumor that needs further investigation. Yet ultrasounds are not always diagnostic, and in certain instances, a mammogram or biopsy is needed to determine or rule out cancer.

Magnetic Resonance Imaging (MRI) is also an imaging choice but has some drawbacks. The majority of breast MRIs employ a contrast material called gadolinium, which is able to pass through the placenta and to the fetus. Although risks are not entirely clear, physicians usually do not use MRI with contrast unless necessary. Some practitioners may offer an MRI without contrast as an option.

What If You Find a Lump In Your Breast During Pregnancy?

Breast changes throughout pregnancy are normal, but finding a lump should never be taken lightly. If you notice a lump, alert your medical provider right away. They will conduct a clinical breast exam and potentially have you get an imaging study such as an ultrasound or mammogram to see whether anything needs to be done.

If imaging indicates a suspicious mass, a biopsy can be suggested. Core needle biopsy is the most frequently used and is safe during pregnancy. It consists of numbing the skin with local anesthetic and inserting a hollow needle into the area to obtain a small sample of tissue to be tested.

Breast Cancer Treatment During Pregnancy

In the extremely uncommon event of a diagnosis of breast cancer while pregnant, therapy will be determined by the nature and extent of cancer and by how far along in pregnancy one is. The most frequent form of treatment is surgery—either mastectomy (surgical removal of the entire breast) or lumpectomy (surgical removal of the lump)—which is usually safe while pregnant.

Chemotherapy is also possible but usually only attempted after the first trimester, when it can damage developing fetal tissue. Radiation therapy is not used during pregnancy and is typically deferred until after giving birth. Hormonal therapy and targeted therapies are also omitted until after giving birth.

Can I Get a Mammogram While Breastfeeding?

Yes, you can have a mammogram while you are breastfeeding. The radiation in a mammogram does not impact breast milk or hurt the baby. But breast density is still high during lactation, and this might complicate detection of abnormalities. To enhance image quality, physicians usually advise breastfeeding or pumping 30 minutes prior to the mammogram.

Routine screening mammograms are usually delayed in pregnancy unless there is a high-level concern.

If a lump is detected, an ultrasound is typically the initial imaging study done, with a mammogram being a consideration if additional assessment is necessary.

• Pregnancy mammograms utilize minimal radiation and are safe when required.
• Breast MRI with contrast is usually avoided in pregnancy.
• Breast biopsy, when necessary, is safe during pregnancy.

If breast cancer does develop during pregnancy, there are available treatment options that can be adjusted to keep the mother and infant safe.

Pregnancy is a period of significant change, and health issues particularly those involving breast health, are anxiety-provoking. Routine mammograms are typically postponed until after giving birth, but diagnostic testing can be done if necessary. The best you can do is discuss changes you notice in your breasts with your healthcare provider in an open manner. Early detection and prompt treatment can make a very big difference in the health of both mother and fetus.

Heart attack is the world's number one killer, yet its symptoms differ for both men and women, leading to varied outcomes.

A heart attack typically occurs when cholesterol plaque builds inside the walls of arteries and causes damage to the major blood vessels.

While men typically develop plaque in the largest arteries that supply blood to the heart, in women, it accumulates in the heart’s smallest blood vessels, known as the microvasculature.

A study published today in Circulation: Cardiovascular Imaging, an American Heart Association journal, showed that women report less artery-clogging plaque. Yet, it did not protect them from heart disease compared to men.

The study showed that women faced increased heart risk at lower levels of plaque compared to men. For total plaque burden, women’s risk began to rise at 20 percent plaque burden, while men’s risk started at 28 percent.

The increasing plaque levels led to a sharper risk for women than for men.

How Heart Attack Symptoms Differ Between Men And Women

According to global studies, women are more likely than men to die from a heart attack. The major reason is the late onset of symptoms of a heart attack in women.

During a heart attack, men are likely to experience sweating, pain in the chest, arms, and legs, and shortness of breath.

While the experiences are common among women, they also tend to suffer a combination of less-recognized symptoms such as nausea, indigestion, fatigue, dizziness, and pain in the neck, jaw, throat, abdomen, or back.

The obvious chest discomfort is also sometimes absent during heart attacks in women.

Other common reasons for heart attacks in women include:

• High testosterone levels before menopause
• Hypertension during menopause
• Autoimmune diseases such as rheumatoid arthritis
• Stress and depression

Can Heart Attacks Be Prevented?

Cardiovascular diseases are mostly preventable by targeting traditional risk factors common to both women and men, which include obesity, smoking, diabetes, high blood pressure, family history and metabolic syndrome -- the co-existence of high blood pressure, obesity, and high glucose and triglyceride levels.

The American Heart Association also advises at least 150 minutes a week of moderate-intensity aerobic activity (such as brisk walking) or 75 minutes of vigorous activity (such as jogging), or a combination of both.

Include fruits, vegetables, lean proteins, whole grains, low-fat or fat-free dairy, nuts, and seeds in your diet.

Limit processed foods, added sugars, sodium, and alcohol.

Seeing your child suddenly screaming at night, with wide eyes and thrashing limbs, can be deeply unsettling. However, remaining calm and focusing on safety is crucial for parents during the sleep terror episodes, said health experts.

Sleep terrors, also known as night terrors, are episodes of sudden fear, screaming, or intense distress that occur during sleep.

The condition is more common in children, especially between the ages of 3 and 8 years, as their sleep patterns are still maturing.

Unlike nightmares, which usually happen during dreaming (REM sleep) and are often remembered, sleep terrors occur during deep non-REM sleep.

Dr Preeti Singh, Senior Consultant, Clinical Psychology, Max Super Speciality Hospital, Dwarka told HealthandMe, that while it may be frightening to witness, especially for parents, sleep terrors themselves are usually not harmful.

Although most kids outgrow this naturally, if the episodes are violent or very frequent, consult a specialist, added Dr Sudhir Kumar, a neurologist at Apollo Hospitals, Hyderabad.

What Are Sleep Terrors

During sleep terror, the child may sit up abruptly, shout, appear frightened, sweat, breathe rapidly, and be difficult to console. In most cases, they do not recall the episode the next morning.

Sleep terrors typically occur in the first third of the night, during deep sleep (slow-wave sleep). They are considered a type of parasomnia, meaning an unusual behavior during sleep.

Dr Kumar, in a post on social media platform X, explained that unlike a bad dream, a sleep terror happens in deep sleep (Stage N3).

It is characterized by abrupt sitting up/screaming, with physical signs that include a fast heart rate, sweating, and dilated pupils.

"It is 11 PM. Your child suddenly sits up, screams at the top of their lungs, and looks terrified. They are not responding to you, and they seem to be looking right through you. This is likely a sleep terror (night terror), a common NREM sleep parasomnia in children aged 3-12,” said Dr Kumar, popularly known as the Hyderabad doctor, on X.

The expert noted that the children are unlikely to recognize the parents and be "consoled" during the episodes.

What Factors Trigger Sleep Terrors

• Sleep deprivation or irregular sleep schedules
• Fever or illness
• Emotional stress or anxiety
• Major life changes or trauma
• Family history of parasomnias
• Certain medications

For children, sleep terrors are often developmental and tend to reduce as the nervous system matures, Dr Singh told HealthanMe.

How Can Parents Respond?

Parents often feel alarmed during a sleep terror episode, but the key is to remain calm, the experts said. They said during an episode:

• Do not try to fully wake the child, as this may increase confusion and agitation.
• Gently ensure the child is safe and cannot injure themselves.
• Speak softly and reassuringly, even if they do not respond.
• Wait for the episode to pass, which usually happens within a few minutes.

Other preventive measures include:

• Maintaining a consistent bedtime routine
• Ensuring the child gets adequate sleep
• Reducing screen time before bed
• Managing stress during the day
• Creating a calm and secure sleep environment

How To Manage

Most children do not require medical treatment, as sleep terrors usually resolve on their own with age. Treatment is considered when episodes are frequent, severe, cause injury, or significantly disrupt family life.

However, addressing sleep deprivation, treating any underlying medical conditions (e.g., sleep apnea), counseling or stress management strategies can help.

Hypertension or high blood pressure, a major risk for stroke, is preventable and treatable. Yet it accounts for about 14 per cent of cases of stroke among young adults aged below 45 years.

High blood pressure can be defined as the increasing pressure in blood vessels marked as 140/90 mmHg or higher.

Uncontrolled hypertension can burst or block arteries that supply blood and oxygen to the brain, causing a stroke.

A recent study by the Indian Council of Medical Research (ICMR) found that hypertension (74.5 percent) was the most common risk factor for stroke and related deaths (27.8 percent) and significant disability (about 30 per cent) across India.

“Blood vessel walls can be damaged through uncontrolled high blood pressure, making them prone to blockage or rupture. The good news is that hypertension is preventable through regular monitoring, reduced intake of salt, exercise stress control, and medication when required,” Dr. Rajul Aggarwal, Director - Neurology, Sri Balaji Action Medical Institute, Delhi, told HealthandMe.

How Does Hypertension Increase The Risk Of Stroke?

Chronic high pressure forces the brain to compensate, leading to vessel remodeling, narrowing, and eventually rupture or clotting.

The ICMR study reported that ischemic stroke accounted for 60 percent of cases.

The experts explained that in the case of ischemic stroke, high blood pressure damages artery walls, fostering plaque buildup (atherosclerosis) or allowing clots to form and block blood flow to the brain.

On the other hand, with hemorrhagic Stroke, constant strain caused by high blood pressure weakens artery walls, causing them to burst or leak blood into the brain. This can result in severe damage or life-threatening emergencies.

“When blood pressure stays high for years, it slowly strains the blood vessels -- nothing dramatic at first, which is why people ignore it. The arteries become stiff and fragile, sometimes narrowing, sometimes tearing,” Dr. Gunjan Shah, Interventional Cardiologist, Narayana Hospital, Ahmedabad, told HealthandMe.

"This makes clots or bleeding in the brain more likely, leading to ischemic or hemorrhagic stroke, even in people who otherwise feel perfectly fit and busy with daily life," Dr. Shah added.

Importance of the ‘Golden Hour’ In Stroke Care

In stroke-related cases, the golden hour -- referred to as the critical first 60 minutes after symptom onset -- is very much critical. Early medical treatment during the window can prevent death risk as well as boost health outcomes.

However, the ICMR study, published in the International Journal of Stroke, showed that just 20 percent of patients arrived in the hospital after 24 hours of the onset of symptoms.

Dr. Aggarwal said treatment within the first 60 minutes can significantly reduce the brain damage and improve survival as well.

“In a stroke, time moves very differently. Brain cells begin getting damaged within minutes when blood flow stops. If someone reaches the hospital quickly -- within the golden hour -- we have a real chance to restore circulation and limit disability. Recognising symptoms early and not waiting at home can truly change how well a person recovers,” added Dr Shah.

How Can Hypertension And Stroke Be Prevented?

Hypertension is a modifiable disease, and the risks can be reduced by:

• Cutting down and managing stress
• Checking blood pressure regularly
• Treating high blood pressure
• Eating less salt
• Staying active
• Managing stress
• Sleeping properly
• Avoiding tobacco

Dr Shah said that many young patients delay care because they feel fine, but taking medicines on time and correcting lifestyle early can prevent serious problems later.