An air raid on the rebel-held eastern half of the Syrian city of Aleppo has hit the area’s largest hospital for the second time in a matter of days, a medical charity says.
The Syrian American Medical Society, which supports the hospital, said it had been struck by barrel bombs.
The same facility was hit in a similar attack on Wednesday.
There are also reports of Russian-backed Syrian government forces hitting Aleppo’s historic Old City.
And clashes between government troops and rebels on the ground are said to be occurring in several Aleppo neighbourhoods.
Russian and Syrian air forces resumed attacks on the rebel-held east of the city after a partial truce lapsed on 19 September.
Government forces have also launched a ground offensive against the rebels.
The mounting civilian death toll has sparked international protests. The US says Russia is driving moderate rebels into the arms of jihadists.
Once Syria’s commercial and industrial hub, Aleppo has been divided roughly in two since 2012.
The UN says at least 400 civilians, including many children, have been killed in the city this week as a result of Russian and Syrian government attacks.
‘Trapped in hospital’
A spokesman for the Syrian American Medical Society, a non-governmental organisation, told AFP news agency that two barrel bombs – improvised devices dropped from helicopters – had hit the hospital it supports.
“There were reports of a cluster bomb as well,” Adham Sahloul said.
The M10 hospital was said to be out of service after it was bombarded on Wednesday but Mr Sahloul said a small group of patients and staff had been inside when the bombing began and remained trapped there.
Hospital administrator Mohammad Abu Rajab made an urgent appeal for help on Saturday from inside M10, AFP adds.
“The hospital is being destroyed! SOS, everyone!” he was quoted as saying.
French Foreign Minister Jean-Marc Ayrault condemned the bombing of the hospital, saying the shelling of healthcare structures and personnel constituted war crimes.
“Their perpetrators will be held to account,” he said on Saturday. “France is mobilising at the Security Council as we speak to put a stop to this unacceptable tragedy.”
The Syrian army says it is gaining ground but the rebels deny this.
“They are shelling the Old City heavily after another failed attempt to gain ground,” Abu Hamam, from the Failaq al-Sham group, was quoted as saying by Reuters news agency.
“They have lost several fighters and we are steadfast.”
The Syrian Observatory for Human Rights, a UK-based monitoring group, also reported government barrel bomb and jet attacks on the Ghouta area outside Damascus on Saturday.
In another development, it said government forces were battling fighters from the Islamic State group in Homs region.
War of words
Washington and Moscow have continued to spar over Syria, with the US dismissing Russian accusations that it was protecting a jihadist group in its bid to oust Syrian President Bashar al-Assad.
Russian Foreign Minister Sergei Lavrov said the US had broken its promise to separate the powerful Jabhat Fateh al-Sham (formerly known as al-Nusra Front) and other extremist groups from more moderate rebels.
State department spokesman Mark Toner said the Russian allegations were “absurd”.
He told reporters the US had not targeted al-Nusra for months because they had become “intermingled” with other groups and civilians.
The US says it may end co-operation with Russia over its action in Syria.
Mr Lavrov made his claims of US broken promises during an interview with Stephen Sackur on BBC World News TV on the first anniversary of the beginning of the Russian air campaign in Syria.
“They [the US] pledged solemnly to take as a priority an obligation to separate the opposition from Nusra,” he said.
“They still, in spite of many repeated promises and commitments… are not able or not willing to do this.”
At least 250,000 people have been killed in the conflict since it began in March 2011 with the Observatory estimating the true number to be about 430,000.
More than 4.8 million people have fled abroad, and an estimated 6.5 million others have been displaced within the country, the UN says.