Syrian regime forces clashed Wednesday (February 28th) with opposition fighters on the outskirts of Eastern Ghouta despite a "humanitarian pause" announced by Russia and now in its second day, AFP reported.

The Syrian Observatory for Human Rights said the fighting was fierce and broke out overnight in the opposition-held enclave on the eastern outskirts of the capital Damascus.

Early Wednesday, before the daily "humanitarian pause" took effect again, Syrian forces also pounded Eastern Ghouta with airstrikes and artillery fire, Observatory head Rami Abdel Rahman said.

He said regime forces took advantage of the "intensive bombardment and the clashes on the edge of Eastern Ghouta to make a limited advance in the Hosh al-Zawahira and Shaifuniyeh districts".

On Monday, Russian President Vladimir Putin ordered a five-hour daily "humanitarian pause" to allow aid deliveries to the battered enclave and the evacuation of residents.

The Observatory said airstrikes and artillery fire on the enclave stopped just before the "pause" kicked in again Wednesday, but on the ground the clashes continued around Hosh al-Zawahira and Shaifuniyeh.

The bodies of six people were pulled out of the rubble across the enclave, bringing the total number of civilians killed there since February 18th to 590, the Observatory said.

Almost a quarter of those killed are children.