Government and allied forces backed by Russian warplanes have been battling jihadist fighters and rebels for over a week in an area straddling the border between Idlib and Hama provinces.
The air strikes targeted the town of Khan Subul in the centre of Idlib province, the Britain-based Syrian Observatory for Human Rights said.
"There were at least seven dead, five children and two women," the Observatory said.
"We do not know if these were air strikes by the Syrian regime or the Russians," Observatory head Rami Abdel Rahman told AFP.
"Displacement sites are reportedly overwhelmed. Some services are 400 per cent above their planned capacity to serve," the United Nations Office for the Coordination of Humanitarian Affairs said.
An AFP correspondent said there were fresh clashes today.
A column of white smoke could be seen rising into the sky after a regime air strike in the town of Al-Tamana and rebels were firing artillery at government positions.
Idlib province -- currently dominated by a former Al- Qaeda affiliate -- was one of four "de-escalation zones" agreed to help halt fighting around the country by regime backers Russia and Iran and rebel supporter Turkey.
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