An air raid on the rebel-held eastern half of Aleppo in Syria 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.
A destroyed ambulance sits among the rubble of a hospital in Aleppo, Syria, that was hit by a barrel bomb during sustained airstrikes on the city. Photo: AFP
The same facility was hit in a similar attack on Thursday (NZT).
There are also reports of Russian-backed Syrian government forces hitting Aleppo's historic Old City, while 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.
Hospital manager Dr Abu Rajan told local media that about 10 people at the hospital had been injured after it was hit by barrel bombs - improvised devices dropped from helicopters - cluster munitions, and a chlorine bomb.
"Intensive care unit is out of order and the oxygen concentrator has been severely damaged," he said.
"Thank God the patients did not get hurt and they were all transferred to different locations.
"But the place is out of service and the medical ventilator has been damaged as well."
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 have to be held to account," he said in a statement on Saturday. "France is mobilising at the Security Council as we speak to put a stop to this unacceptable tragedy."
A hospital in Aleppo, Syria, was bombed twice in as many days during airstrikes on Aleppo, Syria. Photo: AFP
'Shelling heavily'
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 said.
"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.
US State Department spokesman Mark Toner said the Russian allegations were "absurd".
The US had not targeted al-Nusra for months because they had become "intermingled" with other groups and civilians, he told reporters.
The US says it may end co-operation with Russia over its action in Syria.
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.