This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Diagnosis in obstetrics, Subject name: Gynaecology & Obstetrics
On Doppler the most ominous sign indicating fetal compromise is : 
Select and explain. 
A. pulsatility index in umbilical aery, B. increased resistance in uterine aery, C. increased PSV in middle cerebral aery, D. Absent diastolic flow in umbilical aery
D: Absent diastolic flow in umbilical aery
Answer: D: Absent diastolic flow in umbilical aery 
Explanation: Fetuses with absent end diastolic volume have a poorer outcome than those with only reduction in EDF with majority being delivered by Caesarean section.The morbidity from necrotizing enterocolitis and cerebral haemorrhage is also higher. refer pgno:513 sheila textbook of obstetrics 2 nd edition.