In which of the following conditions a medical treatment of ectopic pregnancy contraindicated?

Medical management (methotrexate) is the treatment of choice for an ectopic pregnancy whenever the required criteria are fulfilled- Patient should be hemodynamically stable (unruptured tubal ectopic pregnancy). Foetal cardiac activity absent (presence of cardiac activity is a relative contraindication). b-hCG levels <5,000 mIU/mL (levels > 5,000 micro IU/mL is a relative contraindication). Gestational sac diameter <4 cm. Free fluid in POD <100 mL.