The paper gives some current approaches to the management of pregnants with diabetes mellitus, in terms of perinatal medicine. These are based on a comprehensive detailed clinical examination of 104 patients, which involves the hormonal fetoplacental complex function, hypophyseothyroidal system, hemocoagulative system by using ultrasonic tools (fetal biometry and echocardiography, Doppler echometric studies of the fetoplacental blood flow in the umbilical vein, funic artery, and fetal aorta). A differential approach was proposed to the management of pregnancy and delivery of patients with diabetes mellitus, which allows perinatal mortality to be reduced.