fetal heart rate questions

[expert@preeclampsia.org]

i'm currently 23 weeks pregnant and diagnose with chronich hypertension at 15 weeks, my Bp has been within range this past month between 125/85 and 130/90. My ob hasn't put me on bed rest or on any medication all he says is to watched for headches and take my bp on regular basis and if it ever goes over 140/100 to to L&D and get check out, my protein came back at 405 mg at 16 weeks.

Now my concern is that I had my regular prenatal visit this past saturday and while the nurse was checking on the baby's heart rate, it came back being over 180 the doctor seemed concern i was never told exactly how high it was and was told to go back home and come back in an hour to repeat the doppler. now when i came back the baby's heart rate had gone down to 148.

my doctor just send me on my way without any warnings to what to look for or any explanations as to why this could have happen even though I asked. I'm worry that this can happen again without my knowledge, between visits without anyone catching it and doing something about it,and maybe this could hurt my baby if it goes unnotice. so is there anything that you can recomend as far what to look for in case my baby's heart rate jumps up again! why did this happen? should i request additional test to find an underlying issue with the baby?

i'm also worry because out of 16 appoitments i've had only half of them they had been able to detect a heart beat via doppler. i'm worry my baby could lack of oxygen and be severely impared or worst die. I just feel that my doc isn't taking my situation serious enough and maybe he may missed something critical in the baby's development while still in the womb.

with my other pregnancy i had routine non-stress test. and i was put on bed rest as soon as my protein came back at 485 at 34 weeks.

thank you for your time and any suggestion or advise.

[expert@preeclampsia.org]

Normal fetal heart rate ranges between 120-160 beats per minute throughout most of gestation; toward the end of pregnancy the normal rate may range in the 110-120 rates. It is not unusual for a fetal heart to accelerate into the 160-180 range after movement, articularly in the last third of pregnancy. Such an acceleration is usually transient.

A sustained fetal heart rate above 160 beats per minute can indicate number of things including an inflammatory/infectious condition involving the pregnancy, a fetal heart structural or rate problem, a thyroid condition, possibly a response to what the mother ate/drank/took medicinally, or be idiopathic--"it happened but the significance or cause is unclear". The obstetrician is thinking of these things and making a decision of whether a faster than average fetal heart rate is incidental or something to be followed up further.

A reactive fetal heart rate is a reassuring thing, accelerating 15 beats per minute for 15 seconds or more at or beyond 32 weeks gestation, in response to fetal movement much like an adult heart speeds up when that person changes position or becomes more active.