Defying global calls for a ceasefire, Syria's government has pursued a ferocious Russian-backed air campaign and ground offensive to capture the region, the last rebel bastion on the capital's doorstep.
In three weeks of fighting, it has overrun more than half the area and split the remainder into three pockets, isolating the urban hub of Douma from the rest of the enclave.
Today, government troops battered the edges of each pocket with air raids, barrel bombs, and rockets, said the Britain-based Syrian Observatory for Human Rights.
State news agency SANA had reported troops were focusing on the town in order to cut rebel access routes in Ghouta.
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Bombing runs across several towns in Ghouta killed a dozen civilians on Sunday, bringing the total toll from the offensive to at least 1,111 civilians, the Observatory said.
They include dozens of decomposing bodies still trapped under pulverised residential blocks in the towns of Hammuriyeh, Saqba, and Misraba.
In Hammuriyeh, AFP's correspondent saw a young man scrambling frantically over the rubble of a collapsed building in search of his loved ones.
Hassaan, a 30-year-old rescue worker, said there were around 20 more families under the rubble.
"We need heavy machinery to get them out, but we can't bring the machines out into the streets because the regime may bomb them," he said.
In the main town of Douma, bodies piled up in the morgue as bombardment prevented families from reaching the cemetery, AFP's correspondent there said.
Families grew desperate for news of loved ones who had fled to other areas that were now inaccessible.
Government forces also captured the town of Misraba.
Some residents fled from the advancing troops, but dozens stayed as soldiers recaptured their neighbourhoods.
SANA reported on Sunday that troops transported "dozens of civilians, including women and children," from Misraba to temporary shelters in government-held zones.
The Observatory told AFP that Misraba was left abandoned after 75 to 100 people were moved out of the town by regime forces.
Syrian President Bashar al-Assad is keen to recapture Eastern Ghouta from rebels, who have used the region as a launch pad for attacks on the capital.
It broadcast live footage from the battered skyline of Medeira, saying Sunday's gains linked Syrian soldiers advancing from the east with troops based on the western edges of Ghouta.
In recent years, government forces have recaptured several areas around Damascus and other parts of war-ravaged Syria from rebels by pursuing fierce military offensives culminating in evacuation deals.
A delegation representing Hammuriyeh residents were on Sunday considering such an agreement after talks with the regime, a negotiator and the Observatory told AFP.
"The committee is meeting on Sunday to take a decision and inform the regime," the source told AFP on condition of anonymity.
The Observatory confirmed talks were taking place on Hammuriyeh as well as the towns of Jisreen and Saqba.
The two main rebel groups in Eastern Ghouta have firmly and repeatedly denied negotiating with the Syrian regime.
Faylaq al-Rahman, the opposition faction that holds Hammuriyeh, insisted late Saturday there were "no direct or indirect negotiations" on an evacuation.
The United Nations has demanded a month-long ceasefire there to allow for aid to be brought in and for desperately sick and wounded civilians to seek treatment.
Syria's regime has also been accused of using chlorine gas against civilians in Eastern Ghouta in recent weeks.
On Sunday, US Defence Secretary Jim Mattis warned it would be "very unwise" for Assad to use weaponised gas against civilians, but delined to say whether doing so would trigger a US military response.