Air strikes have hit a hospital in a rebel-held area of Syria’s Aleppo killing at least 27 people, including three children and the city’s last paediatrician, according to reports from medics and an observatory body.

The al-Quds hospital was supported by international medical charity Doctors Without Borders (MSF), who said the facility was destroyed after being hit by a direct air strike that killed at least three doctors.

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The head of a rescue service put the death toll at 50, saying most of the dead were in a building next door, but reports on the death toll have been conflicting between agencies.

Syrians carry a body from the site of the attack. Photo: Getty

“Destroyed #MSF-supported hospital in Aleppo was well known locally and hit by direct airstrike on Wednesday. Hospitals are #notatarget,” an MSF Twitter account said.

It is still uncertain who was behind the air strike that hit the hospital — Syria’s armed forces quickly denied reports that it targeted the hospital on state television, while Russia has always denied targeting civilian targets in Syria.

A US State Department official said indications were that the bombing was solely the work of Syrian Government forces.

The White House condemned the wave of airstrikes in Aleppo, saying it was “particularly appalled” by the hospital attack.

“We strongly condemn the wave of airstrikes and shelling that have killed more than 60 people in Aleppo in just the last 24 hours,” spokesman Josh Earnest said.

US Secretary of State John Kerry said Russia had an “urgent responsibility” to press the Assad Government to stop attacking civilians.

Aleppo has been the epicentre of a military escalation that has helped to undermine UN-led peace talks in recent weeks.

A cessation of hostilities agreement has unravelled and fighting has resumed on numerous fronts in western Syria.

Pro-government newspaper Al-Watan said the army was preparing for a “decisive battle” for Aleppo and the surrounding province while a source close to the regime said the campaign was imminent.

The Britain-based Syrian Observatory for Human Rights said 31 people were killed as a result of air strikes on several areas of opposition-held Aleppo on Thursday, in addition to the 27 it said died in the hospital strike.

We condemn the destruction of the Al Quds hospital in #Aleppo, depriving people of essential healthcare. Hospitals are #notatarget, #Syria

— MSF International (@MSF) April 28, 2016