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icareCTG Team

Our icareCTG team combines clinical experience, international backgrounds, and an innovative approach to transform training in fetal monitoring.

Anna Gràcia Director and Speaker of icareCTG

Anna Gràcia

Director and Speaker of icareCTG

Anna completed her specialty in Gynecology and Obstetrics at the Vall d’Hebron Hospital. She was awarded an EBCOG European Scholarship in 2014, which allowed her to complete an honorary clinical fellowship in high-risk obstetrics at St George’s Hospital. There, she worked with Dr. Chandraharan and began her passion for fetal monitoring.

After completing her residency, she extended the fellowship to complete her training. During that time, she published different papers and carried out an audit for the CNST (NHS).

She regularly participated as a speaker in Fetal Monitoring Masterclasses in the UK and Ireland since 2015. In 2016, she created icareCTG, a divulgative project with Dr. Chandraharan and Dr. Susana Pereira, whose objective is to offer training in fetal monitoring based on pathophysiology to gynecologists and midwives in Spanish-speaking countries. Since its inception, it has held 20 masterclasses, with more than 5000 students in total.

Anna is part of the Board of Physiological-CTG interpretation and is co-author and peer-reviewer of the Guideline based on fetal physiology for interpretation of the CTGs, implemented in 14 countries. She is a member of the CTG Masterclass training team in the UK and abroad.

Anna leads different multicenter scientific studies and is pursuing a doctorate in fetal monitoring. She has made several publications on this topic in international journals and is the author of different book chapters.

She is a member of the Perinatal Medicine section of the Catalan Society of Obstetrics and Gynecology. She is also part of the Working Group for the study and prevention of Obstetric Violence (GTepVO).
Anna is an expert specialist of the College of Physicians of Barcelona for Obstetrics cases that involve cardiotocographic records.

Yan-ju J, Tullio, Pereira S, Gracia-Perez-Bonfils A, Chandraharan E. Pathophysiology of Fetal Heart Rate Abnormalities: understanding fetal compensatory responses on the Cardiotocograph (CTG). Accepted for publication. American Journal. 2023

Anna Gracia Perez-Bonfils; Edwin Chandraharan. Fetal Compromise: Diagnosis and Management. Obstetric and Intrapartum Emergencies: A Practical Guide to Management. Cambridge University, 10/11/2021.

Gracia-Perez-Bonfils, A, Martinez-Perez O, Llurba E, Chandraharan E. Fetal heart rate changes on the cardiotocograph trace secondary to maternal COVID-19 infection. Eur J Obstet Gynecol Reprod Biol. 2020;252:286-293. Cited 4 times.

Gracia-Perez-Bonfils, A, Chandraharan, E Does the Saltatory pattern on cardiotocograph (CTG) trace really exist? The ZigZag pattern as an alternative definition and its correlation with perinatal outcomes. The Journal of Maternal-Fetal & Neonatal medicine. 33 (2018). Taylor&Francis. DOI 10.1080/14767058.2019.1686475

Anna Gracia Perez-Bonfils; Edwin Chandraharan. Understanding Fetal Oxygenation. CTG Interpretation: From Patterns to Physiology.Cambridge University Press, 23/02/2017.

Andrea Gascon Portales, María Goya Canino, Manel Mendoza Cobaleda, Anna Gracia Perez Bonfils, Teresa Higueras, Ines Calero, María Ángeles Sanchez, Elisa Llurba Olivé, Lluís Cabero Roura, Elena Carreras Moratonas. Intraobserver and interobserver variability in first trimester transvaginal ultrasound cervical length. The Journal of Maternal-Fetal & Neonatal medicine. 33 (2018). Taylor&Francis. DOI 10.1080/14767058.2018.1487939

Anna Gracia Perez-Bonfils; Edwin Chandraharan. Pathophysiology of CTG and Types of Intrapartum Hypoxia. CTG Interpretation: From Patterns to Physiology. Cambridge University, 23/02/2017.

Anna Gràcia Perez-Bonfils. Gynaecological History and Examination. Essentials of Gynecology. Jaypee Brothers Medical Publishers, 10/06/2016.

Anna Gracia Perez-Bonfils; Edwin Chandraharan. Impact of a physiology-based “Predictive” CTG Training on the knowledge of types of intrapartum fetal hypoxia amongst midwives and obstetricians. J.Perinat.Med. pp. 152. Walter de Gruyter, 15/10/2015.

Anna Gràcia Perez-Bonfils, Edwin Chandraharan. Fetal compromise: Diagnosis and Management. Chapter In: Obstretric and intrapartum emergencies: A practical guide to management. Cambridge University Press. 2014.

Susana Pereira Director and Speaker of icareCTG

Susana Pereira

Director and Speaker of icareCTG

Susana is a clinical lead at the Royal Hospital in London and a sub-specialist in fetal medicine. Originally from Portugal, she graduated from the University of Porto in 1998. After finishing, she volunteered in Africa (Sao Tome and Principe) where she began her passion for gynecology and Obstetrics. She completed her residency in Portugal and a fellowship in Fetal Medicine at King’s College Hospital with Prof Nicolaides.

Later in Portugal, she launched the Fetal Medicine unit and directed it for 3 years. In 2014, she returned to London to complete her sub-specialty in Fetal and Maternal Medicine at King’s College.

In 2015-2017, she worked as an attending physician at Kingston Hospital and led the patient safety project, introducing interpretation based on pathophysiology, with improvement of perinatal results, morbidity, and mortality. The project was selected to receive the HSJ award in 2017 and 2018 in the categories of Maternity and midwifery service and training and education.

Susana is part of the CTG Masterclass training team in the UK and abroad and is part of the Board of Physiological-CTG. She is also a PROMPT (Practical Obstetric Multi-Professional Training) instructor. In 2015, she received an “Excellent Teaching” certificate at St George’s University and was nominated “Trainer of the Year” by the residents of South London.

She currently works as a clinical lead at the Royal Hospital. She is passionate about improving perinatal outcomes, likes multidisciplinarity in the delivery room, and the speed of decision-making that is sometimes required.

  • Implementation of physiological interpretation of fetal heart rate changes: from scientific principles to frontline practice. Chandraharan E, Mappa I, Gracia Perez-Bonfils A, Pereira S. JMatern Fetal Neonatal Med. 2026Dec;39(1):2612451. doi: 10.1080/14767058.2025.2612451. Epub 2026 Jan 14. PMID: 41535023.
  • Intrapartum recognition and management of fetal inflammation. di Pasquo E, Pereira S, Valentini B, Familiari A, Ghi T. Eur J Pediatr. 2026Jan 15;185(2):81. doi: 10.1007/s00431-025-06738-w. PMID: 41540173.
  • A pragmatic approach to recognize intrapartum chorioamnionitisPereira S, Costa P, Oumar M, Garcia-Ruiz I. Eur J Obstet Gynecol Reprod Biol. 2025 Feb;305:199-203. doi: 10.1016/j.ejogrb.2024.12.012. Epub 2024 Dec 9. PMID: 39705989.
  • Rational approach to fetal heart rate monitoring and management during the second stage of labor.Chandraharan E, Kahar Y, Pereira S, Fieni S, Ghi T. Eur J Obstet Gynecol Reprod Biol. 2025 Feb;305:159-169. doi: 10.1016/j.ejogrb.2024.12.005. Epub 2024 Dec 12. PMID: 39701011.
  • Relative uteroplacental insufficiency of labor. Ghi T, Fieni S, Ramirez Zegarra R, Pereira S, Dall’Asta A, Chandraharan E. Acta Obstet Gynecol Scand. 2024 Oct;103(10):1910-1918. doi: 10.1111/aogs.14937. Epub 2024Aug 6. PMID: 39107951.
  • Long-Term Neurologic Consequences following Fetal Growth Restriction: The Impact on Brain Reserve.Shah DK, Pereira S, Lodygensky GA. Dev Neurosci. 2024 May 14:1-8. doi: 10.1159/000539266. Epub ahead of print. PMID: 38740013.
  • International expert consensus statement on physiological interpretation of cardiotocograph (CTG): First revision (2024)Chandraharan E, Pereira S, Ghi T, Gracia Perez-Bonfils A, Fieni S, Jia YJ, Griffiths K, Sukumaran S, Ingram C, Reeves K, Bolten M, Loser K, Carreras E, Suy A, Garcia-Ruiz I, Galli L, Zaima A.. Eur J Obstet Gynecol Reprod Biol. 2024 Nov;302:346-355. doi: 10.1016/j.ejogrb.2024.09.034. Epub 2024 Oct 2. PMID: 39378709.
  • Is the fetus fit for labor? Introducing fast-and-frugal trees (FFTrees) to simplify triage of women for STAN monitoring: An interobserver agreement comparison with traditional classification Pereira S, Bakker P, Zaima A, Ghi T, Kessler J, Timonen S, Vayssière C, Löser K, Holmberg K, Jacquemyn Y, Chandraharan E, Wertheim D, Olofsson P. Acta Obstet Gynecol Scand. 2024 Jan;103(1):68-76. doi: 10.1111/aogs.14680. Epub 2023Oct 27. PMID: 37890863; PMCID: PMC10755137.
  • Pathophysiological interpretation of fetal heart rate tracings in clinical practice Jia YJ, Ghi T, Pereira S, Gracia Perez-Bonfils A, Chandraharan E. Am J Obstet Gynecol. (2023) Jun;228(6):622-644. doi: 10.1016/j.ajog.2022.05.023. PMID: 37270259.
  • Physiological CTG categorisation in types of hypoxia compared with MRI and neurodevelopmental outcome in infants with HIE. Pereira S, Patel R, Zaima A, Tvarozkova K, Chisholm P, Kappelou O, Evanson J, Chandraharan E, Wertheim D, Shah DK. J Matern Fetal Neonatal Med. 2022 Dec;35(25):9675-9683. doi: 10.1080/14767058.2022.2050366. Epub 2022 Mar 13. PMID: 35282752.
  • Absence of fetal heart rate cycling on the intrapartum cardiotocograph (CTG) is associated with intrapartum pyrexia and lower Apgar scores, Susana Pereira, Katherine Lau, Carlotta Modestini, David Wertheim & Edwin Chandraharan The Journal of Maternal-Fetal & Neonatal Medicine (2021), DOI: 10.1080/14767058.2021.1940130
  • Recognising Fetal Compromise in the Cardiograph during the Antenatal Period: Pearls and Pitfalls S Pereira, C Ingram, N Gupta, M Singh, E Chandraharan, Asian Journal of Medicine and Health 2020Sep 3 (8): 72-83 https://doi.org/10.9734/ajmah/2020/v18i930238
  • Antenatal corticosteroids and outcomes in gastroschisis: A multicenter retrospective cohort study Carnaghan H, James CP, Charlesworth PB, Ghionzoli M, Pereira S, Elkhouli M, Baud D, Coppi P, Ryan G, Shah PS, Davenport M, David AL, Pierro A, Eaton S; Gastroschisis Study Group. Prenat Diagn. 2020 May 13. doi: 10.1002/pd.5727
  • Human Factors: The Dirty Dozen in CTG misinterpretation, Nzelu O, Chandraharan E, Pereira S Glob J Reprod Med 6(2): GJORM.MS.ID.555683 2018
  • Each Fetus Matters: An Urgent Paradigm Shift is needed to Move away from the Rigid “CTG Guideline Stickers” so as to Individualize Intrapartum Fetal Heart Rate Monitoring and to improve Perinatal Outcomes. Chandraharan E, Tahan ME, PereiraS, Obstet Gynecol Int J 2016; 5(4):168.
  • Successful induction of labor: prediction by preinduction cervical length, angle of progression and cervical elastography. Pereira S, Frick AP, Poon LC, Zamprakou A, Nicolaides KH. Ultrasound Obstet Gynecol. 2014; 44(4): 468-475
  • Preterm labor: screening and prevention (Article in Portuguese) Cubal S, Pereira S, Acta Obstet Ginecol Port 2014:8(3): 276-282
  • Is Early Delivery Beneficial In Gastroschisis?, Carnaghan H, Pereira S, James CP, Charlesworth PB, Ghionzoli M, Mohamed E, Cross KM, Kiely E, Patel S, Desai A, Nicolaides K, Curry JI, Ade-Ajayi N, De Coppi P, Davenport M, David AL, Pierro A, Eaton S., J Pediatr Surg. 2014; 49(6): 928-933
  • First-trimester biochemical markers and small-for-gestational-age infants (Article in Portuguese) Andrade C, Santos J, Pinto AR, Manso P, Pereira S, Acta Med Port. 2014; 27(2): 191-195
  • Contribution of fetal tricuspid regurgitation in first trimester screening for major cardiac defects. Pereira S, Ganapathy R, Syngelaki A, Maiz N, Nicolaides KH, Obstet Gynecol. 2011; 117 (6):1384-91.
  • Prevalence and outcome of absence of ductus venosus at 11-13 weeks, Staboulidou I, Pereira S, Cruz JJ, Syngelaki A, Nicolaides KH, Fetal Diagn Ther. 2011;30(1):35-40
  • Criteria for screening and diagnosis of gestational diabetes mellitus in the first trimester of pregnancy. Placensia W, Garcia R, Pereira S, Akolekar R, Nicolaides KH, Fetal Diagn Ther. 2011;30(2):108-15.
  • Complications of Obesity in Pregnancy. Raposo R, Ferreira C, Fernandes M, Pereira S, Moura P, Arquivos de Medicina, 2011; 25(3): 115-22
  • Body Stalk Anomaly: report of a rare case diagnosed early in pregnancy. Fernandes M, Pinto A, Raposo L, Pereira SL. Advances in Perinatal Medicine, 2010
  • Extensive subchorionic haematoma – a successful pregnancy outcome. C. Ferreira, V. Silva, L. Raposo, A. Portugal, Pereira S. Controversies in obstetrics, Gynecology and Infertility, 2010

Books & Book Chapters

  • Chapter author: Addressing Human Factors contributing to CTG misinterpretation
  1. Pereira (2026) Handbook of CTG Interpretation: From Patterns to Physiology 2nd edition, edited by Chandraharan.
  • Book author: Is the fetus fit for labor? A physiological approach to CTG interpretation

Susana Pereira (2025). Self published. Available on Amazon.

  • Chapter co-author: Multiple gestation: labour and delivery, B. Lemon and S. Pereira

GLOWM – the global Library of Women’s Medicine

An educational Platform for FIGO (February 2021)

  • Chapter co-author: Learning from Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries (MBRRACE) and “Each Baby Counts” (EBC) Reports, Susana Pereira and Edwin Chandraharan

Obstetric & Intrapartum Emergencies: A Practical Guide to Management, edited by Chandraharan & Arulkumaran (2021)

  • Chapter co-author: Addressing Human Factors in Obstetric Emergencies, Susana Pereira and Kim Hinshaw

Obstetric & Intrapartum Emergencies: A Practical Guide to Management, Edited by Chandraharan & Arulkumaran (2021)

  • Multiple chapters author and editor

Problem Based Obstetric Ultrasound (2nd Edition)

Edited By Amar Bhide, Asma Khalil, Aris Papageorghiou, Susana Pereira, Shanthi Sairam and Basky Thilaganathan , Published December 4, (2019) by CRC Press

  • Chapter co-author: Medicolegal Issues in Obstetrics and Gynaecology, Edwin Chandraharan and Susana Pereira, Edited by Swati Jha and Emma Ferriman (2017)
2da Master Edwin

Edwin Chandraharan

Online Speaker

Edwin is the person who, more than 20 years ago, began to critically question everything we do in the delivery room, which had been perpetuated over the years. He applied basic knowledge of general physiology, the advances that have been made in fetal physiology, and applied common sense. With all this, he proposed a different way of working, which has been shown to improve perinatal results.

Edwin was head of service and Lead for Clinical Governance for Obstetrics and Gynaecology from 2005 to 2017 at St George’s Hospital, London. He was also Clinical Director for Women’s services in 2015.

He teaches more than 40 courses a year on fetal monitoring as well as post-partum hemorrhage and obstetric emergencies, among others. He has directed the workshop “Training the Trainers” and has been the coordinator of the course “Basic Practical Skills Course” at the Royal College of Obstetricians and Gynaecologists (RCOG). He is co-organizer at the RCOG of “Intrapartum Fetal Surveillance Course” and one of the members of the Editorial Board of the National E-learning for Healthcare in Electronic Fetal Heart Rate Monitoring.

Dr. Chandraharan has made more than 100 publications between national and international journals and book chapters. Edwin Chandraharan is co-author of the book “Obstetric and Intrapartum Emergencies: A Practical Guide to Management” and “High Risk Pregnancy: Management Options”. In 2015, he was one of the 3 members of the international Committee to review the FIGO Guidelines of CTG, which have been implemented in approx 50 countries. In 2016, he published the book “Handbook of CTG Interpretation: From Patterns to Physiology” (Cambridge University Press, 2016).

He is a reviewer for The Lancet, BJOG, Journal of Perinatal Medicine, The Green Journal and European Journal of Obstetrics, Gynecology and Reproductive Biology and editorial consultant for Labour and Delivery in The Global Library of Women’s Medicine.

Edwin Chandraharan launched and led a multi-disciplinary team of reference at the state level for the management of pregnant women with placenta percreta. He is the author of the surgical technique “Triple P Procedure” that allows a less invasive treatment of the placenta percreta, without the need for hysterectomy and that is currently being implemented in different countries.

In 2017, he received the prestigious BMJ Award for Clinical Leadership in Fetal Monitoring.

In 2019, he was hired as an advisor for intrapartum management by the NHS in Basildon, Broomfield & Southend University Hospitals Mid and South Essex NHS Foundation Trust, Essex.

He is passionate about ensuring quality patient care with a strong focus on team training as a measure to improve, risk management, and patient experience.

Other team members

Agora Events

Event organization agency specialized in medical congresses led by Sandra Simó. They take care of the technical secretariat and logistics of each of the Masterclasses so that the event can be carried out without incidents. Ana Escudero is the icareCTG referent within the agency and is also in charge of social networks. Both Sandra and Ana are a pillar of icareCTG.

Belén Simarro
and Blanca Rissech

They have more than twenty years of experience as conference interpreters, with special interest in medical disciplines and health sciences. From the beginning, they have accompanied us in all the Masterclasses that have required dubbing. They know perfectly the work of icareCTG and Dr. Chandraharan and Susana Pereira, as well as the specific terminology of pathophysiology that we use.

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