Objective - to reveal the specific features of fetal cardiac performance in pregnant patients with diabetes mellitus to predict diabetic fetopathy. Material and methods. Cardiac performance was investigated in 178 fetuses from healthy women with physiological pregnancy (a control group, Group 1) and 162 fetuses from pregnant women with diabetes mellitus (a study group, Group 2). The study group was divided into two subgroups. Subgroup 2a included 65 fetuses without ultrasound signs of diabetic fetopathy and Subgroup 2b comprised 97 fetuses with ultrasound signs of diabetic fetopathy at 30-39 weeks’ gestation. Fetal cardiac performance was analyzed using an echocardiographic examination of fetal left ventricular contractility (ventricular septal contractility index, left ventricular shortening fraction, and left ventricular ejection fraction), examination of volume indices (stroke volume, minute volume) and cardiac index, and determination of the arbitrarily accepted fetal left ventricular mass index. Results. Examination of the specific features of fetal cardiac performance revealed decreased ventricular septal contractility in Group 2 even in the absence of signs of diabetic fetopathy (Subgroup 2a); in this case left ventricular contractility was retained. The stroke volume and minute volume in Subgroup 2b was significantly higher than in Group 1 at 32-33 and 38-39 weeks’ gestation. During these periods, the fetal left ventricular cardiac index was noted to be also higher. Analysis of the conventional fetal left ventricular mass index revealed a difference between Group 1 and Subgroup 2b; just at 32-33 weeks’ gestation and by the full-term gestational period this index in Subgroup 2b was 20% significantly higher than that in the control fetuses. Conclusion. For more accurate diagnosis of fetal hemodynamics in diabetic fetopathy, there is a need to investigate the parameters of fetal cardiac performance. The authors declare no conflicts of interest.