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Background: Weight discordance of ≥ 20 percent is present in 15 percent of twin pairs and mostly the smaller twin’s birth weight <10th percentile and the larger twin is nearer appropriate size for gestational age. We report twin pairs where the larger twin is macrosomic with smaller twin having normal birth weight. We could not find a similar report in the literature.
Case presentation: The twins were born to 29 years old gravida 3 para 2 lady at 38 weeks and 3 days of gestation. The first of twins was male and macrosomic (4500 gm) and his twin sister was of normal birth weight (3500 gm), with 22 percent birth weight discordance.
Conclusion: We report this case as there is no similar report in the literature on abnormal growth of twins with macrosomia and discordance: an out of the box presentation. Both of our cases are large for gestational age an adjustable fetal weight standard for twins.