Please note, the question is 'Which pattern predicts fetal death' hence do not mark 'Absent systolic flow' which no more predicts, but is diagnostic of fetal death. Reversal of diastolic flow most significantly predict the intra uterine deaths of the foetus. Umbilical aery doppler done to assess fetal well being in high risk pregnancy. The order of worsening is estimated in the following sequence Diastolic notching Increased S/D ratio, due to decreased diastolic flow Absent end diastolic flow Reversal of end diastolic flow: most ominous sign, requiring immediate intervention