Fighting broke out east of Damascus between rebel and government forces on Wednesday for the first time since both sides declared a ceasefire at the weekend, a war monitor said, with air strikes also hitting the besieged, rebel-controlled enclave.
Air strikes on three towns in East Ghouta killed a child and wounded 11 other civilians, taking the toll of wounded and dead to about 55 civilians in the last 48 hours, the Syrian Observatory for Human Rights said. The toll is expected to rise.
On Tuesday, the Britain-based monitor reported the first civilian casualties since the Russian-backed truce began on Saturday.
Russia dismissed reports of air strikes on Tuesday as a "an absolute lie" meant to discredit its work in the de-escalation zone.
Wednesday's clashes happened around Ain Terma on the western edge of Eastern Ghouta.
Eastern Ghouta, the only major rebel-held area near the capital, has been blockaded by Syrian government forces since 2013. It has shrunk considerably in size over the past year as the Russia-backed Syrian army has taken control of other rebel-held areas around Damascus.
