In recent years, the investigation of flow velocity in the middle cerebral artery (MCA) has become critical to the clinical management of fetal growth restriction (FGR). The increase in end-diastolic flow velocity, leading to a reduction of the pulsatility index (PI), is a consequence of compensatory cerebral vasodilatation (brain-sparing effect) secondary to fetal hypoxia. According to some authors1–3, cerebral flow velocity may reveal important prognostic signs of imminent fetal death in the presence of a loss of compensatory vasodilatation. This feature is described only sporadically in cases followed up until intrauterine death, providing evidence that it is a late sign and therefore may represent a poor index in FGR management. We report our experience of three pregnancies complicated by severe FGR followed by fetal death between the 25th and the 29th weeks of gestation.