When persistent blood clots are observed after embryonic demise, whether immediate surgery is required depends on the nature of the clots and accompanying symptoms. If the clot volume is small with no signs of infection, medication can usually facilitate expulsion; if the clots are large or cause infection, surgical intervention is needed to remove retained tissue.

Clot formation is often related to retained uterine tissue or stagnant blood. Smaller clots may be naturally expelled with medication, commonly using uterotonics to help eliminate the accumulated material. Patients should monitor changes in bleeding volume during this period and undergo regular ultrasound scans to confirm uterine status. If clots persist or increase after medication, this may indicate significant retained tissue.

When blood clots are large or accompanied by obvious signs of infection, surgery becomes a necessary option. Hysteroscopic surgery can directly remove residual embryonic tissue and blood clots, preventing the spread of infection. Prophylactic antibiotics should be administered postoperatively, along with monitoring of body temperature and discharge. The timing of surgery should be determined based on the size of blood clots, the degree of infection, and the patient's overall condition.

During postoperative recovery, it is important to maintain vulvar hygiene and avoid strenuous exercise. A light and nutritious diet is recommended, with appropriate iron supplementation to prevent anemia. Monitor the amount of bleeding and seek immediate medical attention if abnormal abdominal pain or fever occurs. Postoperative follow-up to confirm uterine recovery is crucial, with an ultrasound examination generally recommended around two weeks later.

There is no need to panic excessively if blood clots appear after embryonic arrest, but they should not be taken lightly either. Seek timely medical evaluation and choose medication or surgical treatment based on the doctor's recommendation to effectively prevent complications. Proper management can maximize protection of the endometrium, creating favorable conditions for future fertility.