**Core Concept**
Ectopic pregnancy is a life-threatening condition where the fertilized ovum implants outside the uterus, most commonly in the fallopian tube. Medical management is a conservative approach used to terminate the pregnancy without surgery.

**Why the Correct Answer is Right**
Medical management of ectopic pregnancy involves the use of medications to terminate the pregnancy and prevent further complications. **Mifepristone**, a progesterone receptor antagonist, is often used in combination with **methotrexate**, a chemotherapeutic agent that inhibits dihydrofolate reductase, to induce abortion. This combination works by disrupting the progesterone-mediated maintenance of pregnancy and inhibiting the growth of the embryo. The goal of medical management is to prevent rupture of the ectopic pregnancy and its associated complications, such as hemorrhage and peritonitis.

**Why Each Wrong Option is Incorrect**
* **Option A:** Medical management is not indicated in cases of ruptured ectopic pregnancy, as surgery is required to prevent further complications.
* **Option B:** Medical management is not suitable for patients with a history of allergy to methotrexate or mifepristone.
* **Option C:** Medical management is not indicated in cases of suspected ovarian pregnancy, as surgery is often required to confirm the diagnosis and prevent further complications.

**Clinical Pearl / High-Yield Fact**
When considering medical management for ectopic pregnancy, it is essential to rule out a viable intrauterine pregnancy, as methotrexate can cause fetal abnormalities if administered during pregnancy.

**Correct Answer:** D