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MOSUL, Iraq A sharp rise in the number of civilians reported killed in U.S.-led airstrikes in Iraq and Syria is spreading panic, deepening mistrust and triggering accusations that the United States and its partners may be acting without sufficient regard for lives of noncombatants.

The increase comes as local ground forces backed by air support from a U.S.-led coalition close in on the Islamic States two main urban bastions Raqqa in Syria and Mosul in Iraq.

In front-line neighborhoods in western Mosul, families described cowering in basements for weeks as bombs rained down around them and the Islamic State battled from their rooftops. Across the border in Raqqa, residents desperately trying to flee before an offensive begins are being blocked by the militants, who frequently use civilians as human shields.

Throughout his election campaign, President Trump pledged to target Islamic State militants more aggressively, criticizing the U.S. air campaign for being too gentle and asking for a reassessment of battlefield rules. The United States has denied there has been any shift and defended the conduct of its campaign.

But figures compiled by monitoring organizations and interviews with residents paint an increasingly bloody picture, with the number of casualties in March already surpassing records for a single month.

[Mosul residents say U.S.-led coalition airstrikes killed scores of people]

The worst alleged attack was in Mosul, where rescue teams are still digging out bodies after what residents describe as a hellish onslaught in the Mosul al-Jadida neighborhood during the battle to retake it two weeks ago. Iraqi officials and residents say as many as 200 died in U.S.-led strikes, with more than 100 bodies recovered from a single building. The wooden carts that residents use to carry vegetables and other wares in the once busy market area instead ferried out cadavers recovered from the rubble last week.

The U.S.-led coalition, which has acknowledged carrying out a strike against militants in the area, says it is investigating the reports. If we did it, and Id say theres at least a fair chance that we did, it was an unintentional accident of war, Lt. Gen. Stephen Townsend, the top U.S. commander for Iraq and Syria, said Tuesday at the Pentagon.

Amnesty International on Tuesday said the coalition was not taking sufficient precautions to prevent civilian deaths in Mosul, in a flagrant violation of international humanitarian law.

It was just one of numerous incidents across Iraq and Syria in recent weeks that have raised concerns that the United States has flouted rules requiring it to protect civilians. In both countries, politicians and activists say the high numbers of deaths are spreading alarm among civilians and sowing distrust of the U.S.-backed campaign advancing toward their homes.

People used to feel safe when the American planes were in the sky, because they knew they didnt hit civilians, said Hussam Essa, a founder of Raqqa is Being Slaughtered Silently, which monitors violence in Raqqa province. They were only afraid of the Russian and regime planes. But now they are very afraid of the American airstrikes. American planes are targeting everywhere, he said.

According to the U.K.-based organization Airwars, which tracks allegations of civilian deaths in airstrikes, out of 1,257 claims of deaths in U.S.-led coalition airstrikes this month, a record 337 have been assessed as being fair, meaning that there is a reasonable level of public reporting of the alleged incident from two or more generally credible sources and that strikes have been confirmed in the vicinity on the day in question.

[Airstrike monitoring group overwhelmed by claims of civilian casualties]

The scale of the destruction is huge, and we are reeling from the number of alleged cases, not just in Mosul but in Raqqa, too, said Chris Woods, the director of Airwars. Casualty numbers from western Mosul are absolutely shocking. In Syria its a car here, a family there. It happens every day.

The group said in a statement last week that it had stopped monitoring Russian strikes in Syria, in order to focus on accusations linked to the U.S.-led coalition, saying its organization is overwhelmed. In the first two months of the year, U.S. strikes were responsible for more civilian casualties than Russian strikes for the first time since Russia intervened in Syrias civil war in 2015, according to Airwars figures. Russian strikes are now climbing again as a partial cease-fire collapses.

Woods said the intensification began during the Obama administration but escalated under Trump. In December, the U.S.-led coalition delegated approval to battlefield commanders in Mosul, speeding up the responsiveness of strikes after a tough battle for the eastern part of the city. The coalition says strikes are subject to the same scrutiny.

The death of innocent civilians in war is a terrible tragedy that weighs heavily on all of us, said Col. Joseph Scrocca, a spokesman for the U.S. military in Baghdad, adding that the United States works within the laws of armed conflict. We set the highest standards for protecting civilians, and our dedication, diligence and discipline in prosecuting our combat operations, while protecting civilians, is without precedence in the history of warfare.

The escalation of U.S. strikes around the city of Raqqa occurred in February as the United States intensified efforts to train and equip a Syrian force in preparation for an offensive against the city, expected to begin in the coming months.

[On the front lines of the fight for the Islamic States capital of Raqqa]

In March, the tempo increased further, with more sites being targeted that have no obvious military value, according to a Syrian living in Turkey who is from Raqqa and is in regular contact with his family and friends who are still there. They are hitting everything that isnt a small house, including the barges that ferry passengers across the river dividing the city now that the bridges have been disabled, he said, speaking on the condition of anonymity because of concern for his family.

Among the bigger incidents was a strike last week on a school sheltering displaced people in the town of Mansoura, outside Raqqa, that killed at least 30 people, according to monitoring groups. An attack on a mosque in western Aleppo that the U.S. military said was aimed at known al-Qaeda operatives also appears to have killed dozens of people attending prayers, according to witness accounts and monitoring groups.

The U.S. military said after the Aleppo strike that it had hit a gathering of militants near a mosque but denied striking the mosque itself. The military is conducting an investigation into the incident.

Townsend said the initial indications were that the school strike was clean and did not kill civilians.

A wave of continued attacks in the past week in the small town of Tabqa has added to a record toll of 101 civilians killed by U.S. strikes from the beginning of the month to March 21, Essa said. He provided the names of 41 people alleged to have been killed in a three-day period last week in strikes that hit a bakery, a carwash, a slaughterhouse and other targets.

In Iraq and Syria, residents and activists say there has also been a discernible shift in the kinds of targets being hit with infrastructure such as hospitals and schools coming under fire. The U.S.-led coalition contends that militants are increasingly using such protected buildings as bases for attack, knowing that there are restrictions on bombing them under U.S. rules of engagement.

Tabqa is a crucial step on the path to Raqqa, and it is the current focus of the battle. Reports that the Tabqa dam have also been hit by airstrikes during the fighting have further contributed to the sense of panic after the Islamic State issued a warning on Sunday that the dam could burst.

Townsend said the United States had not been targeting the Tabqa dam and had been using non-cratering munitions in that area to protect the site.

Downstream from the dam, residents are terrified by the intensified bombing and of the risk of a dam breach, the Syrian said. His family is desperate to escape, but the Islamic State has erected checkpoints to prevent people from fleeing. People dont know what to do, he said.

In Iraq, too, civilians are trapped as Iraqi forces push into the most densely packed areas of Mosul, including the Old City, where an estimated 400,000 people are trapped in old structures on narrow streets.

The United Nations said Tuesday that at least 307 civilians were killed in western Mosul between Feb.17 and March 22, warning Iraqi security forces and the coalition to avoid falling into the Islamic States trap as the group deliberately puts civilians in danger.

With a large amount of artillery and ordnance being fired into the city, though, it is hard to ascertain which deaths the coalition is responsible for, Woods said. Iraqi commanders, who call in airstrikes from the U.S.-led coalition, say its difficult for them to know whether civilians are in houses when many are stuck inside for weeks at a time and it is not possible to see them through drone surveillance.

Lt. Gen. Abdul Ghani al-Asadi, commander of Iraqs counterterrorism units, said the troops are instead relying on tips from those fleeing as to which houses have civilians inside.

Still, Mosul Eye, a monitoring group in the city, said it had warned Iraqi forces that civilians were trapped in homes in Mosul al-Jadida days before the U.S. strike there and sent coordinates.

Amnesty International said that because the government has told residents to stay in their homes, the U.S.-led coalition should have known that strikes would be likely to result in significant numbers of civilian casualties.

For civilians, many of whom are trapped, the situation is dire.

Nour Mohammeds family of 23 people hid in a basement in western Mosul for nearly two weeks as explosions rang out around them.

Islamic State militants forced the family to keep the front door open so that they could move in and out of the building freely and fend off the advancing Iraqi forces from the roof.

We were terrified every time wed hear the sound of an airplane that theyd bomb us all, she said as she fled the city last week.

Sly reported from Beirut. Mustafa Salim in Mosul and Missy Ryan in Washington contributed to this report.

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