Abstract
Acute myeloid leukaemia (AML) in pregnancy is rare and difficult to manage. Here, we describe a case of AML with NPM1 mutation. The patient was counselled regarding the therapy-attributable risks, underwent an elective caesarean section at 33 weeks' gestation, and delivered a morphologically normal fetus. As per WHO guidance, AML treatment should not be delayed. Management requires close collaboration with obstetric and neonatal teams, striking a balance between maternal and foetal survival. Counselling on elective termination should be provided. Treatment decisions should reflect gestational age at diagnosis, maternal tolerance, and drug toxicity. The aim is to complete pregnancy with a viable, healthy fetus and with minimal harm to the mother.