Russian air strikes in the rebel-held Syrian city of Idlib have killed at least 23 people, in the heaviest bombardment since a cessation of hostilities was agreed to in February, the Syrian Observatory for Human Rights says.
The Observatory said the air strikes targeted a number of positions in the city, one of them next to a hospital.
Seven children were among the dead, Observatory Director Rami Abdulrahman said.
The toll was likely to rise with scores of injured, mostly civilians, in a critical condition.
Residents of Idlib said hundreds of families had begun leaving the city for fear of further air raids.
Two rebel sources said Russian jets also intensified strikes on towns in rural Idlib including Binish, Maarat Misreen and Saraqeb.
However, a Russian Defence Ministry spokesman on Tuesday denied it had conducted air strikes overnight against Idlib, calling the Observatory's allegations "a horror story" that should be regarded with scepticism.
Russia deployed warplanes to Syria last year to support President Bashar al-Assad against rebels seeking to end his rule.
The US government said it's following up on press reports about the air strikes near a hospital.
White House spokesman Josh Earnest told a press briefing he couldn't confirm the reports.
"Obviously I've seen them and we are following up on those reports, but if it is confirmed, this strike would be the latest in a series of strikes against medical facilities in Syria.
"The international community needs to get to the bottom of this, and those who are responsible for these strikes need to be held accountable."
The Turkish Foreign Ministry said the air strikes had killed more than 60 civilians and complained in a statement about what it said were the "indefensible" crimes of the Russian and Syrian governments.
It gave no indication how it arrived at the higher toll.
Later the monitor reported that unidentified jets bombed a major camp of the powerful Islamist Ahrar al-Sham insurgent group in Syria's northwestern province of Idlib, leaving a large number of dead and wounded.
The Observatory, which tracks violence across the country, said top trainers from among Ahrar al-Sham's leaders were normally present at the camp, located in the Sheikh Bahar area of rural Idlib.
A senior member of the group, who requested anonymity because he was not authorised to comment, said the report was unfounded but gave no details.
Rescue workers searched for casualties through the night, finding some survivors including a child under the rubble of buildings, the Civil Defence said on its Facebook page.
Idlib city and the province by the same name is a stronghold of rebel groups including the al-Qaeda-linked Nusra Front.
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