The first death associated with the abortion pill, which is close to being approved in Britain and elsewhere in Europe, has occurred in France.

The 31 year old victim, a heavy smoker, had 12 children and a previous abortion. A spokeswoman for Roussel-Uclaf SA, the company that manufactures mifepristone (or RU 486, as it is known), announced "The death was clearly from cardiovascular shock following Nalador injection." Nalador (or sulprostone), manufactured by Schering, is one of several prostaglandins that are administered 36 to 48 hours after the antiprogestogen mifepristone to terminate pregnancies of under nine weeks gestation.

According to The Lancet, this death places the risk of death from the abortion pill at 1.3 per 100,000 abortions, although that risk could rise to a high of nearly 6 per 100,000.

The French Ministry of Health is considering advising doctors that women smoking more than 20 cigarettes a day should not have medically induced abortion.

And because four other deaths have occurred with sulprostone (not used for abortion purposes), Roussel-Uclaf now suggests that other prostaglandins be used with RU 486. The drugs work by inhibiting progesterone levels.

RU 486, which has been approved since April 1990, has been used on more than 60,000 women and now accounts for about a quarter of the abortions done in France.

This development is particularly worrying in light of the fact that at a recent American Association for the Advancement of Science meeting in Washington, researchers discussed the likelihood that the drug will soon be approved to help "ripen" the cervix at the end of pregnancy and also to help to expel the foetus after a second or third trimester death. Scientists are also looking into its use to treat breast cancer and endometriosis.

RU 486 is expected to be approved in the UK this year, and sometime next year in Sweden, Finland, Denmark and Norway.

In America, however, anti abortion groups have succeeded in blocking its use.