Fresh regime strikes on a besieged rebel-held enclave near Damascus killed close to 70 civilians today despite mounting Western pressure on Syrian President Bashar al-Assad.
The bloodshed came a day after another 31 civilians were killed in Eastern Ghouta and as the United Nations pleaded for a truce in the seven-year-old war to allow for aid deliveries.
Eastern Ghouta and Idlib, a northern province where violence also flared this week, are both so-called de- escalation zones under a deal last year intended to pave the way towards an end to the conflict.
A UN-mandated committee however said the recent escalation in violence "made a mockery" of the deal, which has failed to stem the fighting as the Syrian government continues its nationwide military reconquest.
The latest casualties in Ghouta came as Washington threatened military action over the reported use of chemical weapons in the enclave, which regime and allied forces have besieged since 2013.
The death toll there rose from an initial report of 16 to around 70, including 18 children, according to the Syrian Observatory for Human Rights, a Britain-based war monitor. Around 100 people were wounded, it said.
All too familiar scenes of chaos engulfed towns scattered across the semi-rural rebel-held area of Ghouta which lies just east of Damascus.
Rescuers from the White Helmets, an award-winning organisation featured in an Oscar-nominated documentary, could be seen rushing shredded bodies covered in white dust to ambulances hurtling down streets littered with rubble.
Observatory chief Rami Abdel Rahman added that few rebels were among the dead because they rarely left their tunnels and had better protection from air strikes than civilians, estimated to number around 400,000 in Ghouta.
He described today's bloodshed as the deadliest since efforts to broker a truce in Ghouta failed and the government intensified its operations against the enclave six weeks ago.
In apparent retaliation, rockets were fired on several Damascus neighbourhoods, killing three civilians, Syria's state news agency SANA reported.
Several schools in Damascus announced they were suspending classes for the next few days due to the upsurge in violence.
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