Syrian Observatory for Human Rights chief Rami Abdel Rahman said the civilian death toll from Monday´s bombardment of the enclave outside Damascus was the heaviest since early 2015.
The escalation came as pro-government forces were also expected to enter the northern Kurdish-controlled enclave of Afrin, to take a stand against a month-old Turkish assault there.
Held by rebels since 2012, Eastern Ghouta is the last opposition pocket around Damascus and President Bashar al-Assad has dispatched reinforcements there in an apparent concerted effort to retake it.
A barrage of air strikes, rocket fire and artillery slammed into several towns across Eastern Ghouta on Monday.