This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
In a case of ectopic pregnancy, medical treatment is contraindicated if: 
Select and explain. 
A. Sac size is 3.0 cm, B. Serum HCG levels > 1500 miu / ml, C. Significant hemoperitoneum is present, D. Absent fetal activity
C: Significant hemoperitoneum is present
Answer: C: Significant hemoperitoneum is present 
Explanation: Criteria for medical treatment 
1) Ectopic mass <3.5cm – the presence of fetal cardiac activity is a contra-indication to medical treatment
2) No fetal cardiac activity
3) Initial hCG <3000iu/l
4) The patient must be hemodynamically stable, with no signs or symptoms of active bleeding or hemoperitoneum.
5) She should not have any contraindications to the use of methotrexate.