BEIRUT - Residents of Syria's eastern Ghouta district said they were waiting for their "turn to die" on Wednesday after rockets and barrel bombs fell on the besieged rebel enclave targetted for days by some of the most intense bombardment of the war.
At least 10 people died in one village and more than 200 were injured early on Wednesday.
At least 274 people have been killed in the district in the last three days, the British-based Syrian Observatory for Human Rights war monitor said.
Another 13 bodies, including those of five children, were recovered from the rubble of houses destroyed on Tuesday in the villages of Arbin and Saqba, the Observatory reported.
Ghouta, a densely populated agricultural district on the outskirts of Damascus, is the last major area near the capital still under rebel control.
The district, home to 400,000 people, has been besieged by government forces for years.
A massive escalation in air strikes since Sunday has become one of the most intense of the Syrian civil war, now entering its eighth year. The United Nations has denounced the bombardment, which has struck hospitals and other civilian infrastructure, saying such attacks could be war crimes.
The pace of the strikes appeared to slacken overnight, but its intensity resumed later on Wednesday morning, the Observatory said. Pro-government forces fired hundreds of rockets and dropped barrel bombs from helicopters on the district's towns and villages.
"We are waiting our turn to die. This is the only thing I can say," said Bilal Abu Salah, 22, whose wife is five months pregnant with their first child in the biggest eastern Ghouta town Douma.
They fear the terror of the bombardment will bring her into labour early, he said.
"Nearly all people living here live in shelters now. There are five or six families in one home. There is no food, no markets," he said.
A commander in the coalition fighting on behalf of Assad's government told Reuters overnight that the bombing aims to prevent the rebels from targeting the eastern neighbourhoods of Damascus with mortars. It may be followed by a ground campaign.
"The offensive has not started yet. This is preliminary bombing," the commander said.
The Syrian government and its ally Russia, which has backed Assad with air power since 2015, say they do not target civilians. They also deny using the inaccurate explosive barrel bombs dropped from helicopters whose use has been condemned by the United Nations.
Conditions in eastern Ghouta, besieged since 2013, had increasingly alarmed aid agencies even before the latest assault, as shortages of food, medicine and other basic necessities caused suffering and illness.
Rebels have also been firing mortars on the districts of Damascus near eastern Ghouta, wounding two people on Wednesday, state media reported. Rebel mortars killed at least six people on Tuesday.
"Today, residential areas, Damascus hotels, as well as Russia’s Centre for Syrian Reconciliation, received massive bombardment by illegal armed groups from eastern Ghouta," Russia's Defence Ministry said late on Tuesday.
Eastern Ghouta is one of a group of "de-escalation zones" under a diplomatic ceasefire initiative agreed by Assad's allies Russia and Iran with Turkey which has backed the rebels. But a rebel group formerly affiliated with al-Qaeda is not included in the truces and it has a small presence there.