Yesterday's 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 yesterday.
"The regime is bombing Eastern Ghouta to pave the way for a ground offensive," said Observatory head Rami Abdel Rahman.
The main opposition National Coalition, which is based in Turkey, denounced the "war of extermination" in Eastern Ghouta as well as the "international silence".
In a statement, it also accused regime ally Russia of seeking to "bury the political process" for a solution to the conflict.
Residents of Hammuriyeh could be seen rushing indoors in panic as soon as they heard the sound of airplanes.
"Ghoutas fate is unknown. Weve got nothing but Gods mercy and hiding out in our basements," he told AFP. "Theres no alternative."
Shelling also hit the town of Douma, where an AFP correspondent saw five toddlers brought to a hospital, covered in dust and wailing uncontrollably.
The hospital was full of distraught civilians: one father slapped his forehead after finding his two dead children, another erupted into tears as he discovered the body of his newborn on a purple sheet next to a pool of blood.
The Observatory and Syrian daily newspaper Al-Watan had said negotiations were under way for the evacuation of jihadists from Eastern Ghouta.
But escalating military pressure indicate that the regime would opt for a ground assault instead of talks, the monitor said.
Government troops carried out a relentless five-day bombing campaign earlier this month that killed around 250 civilians in the enclave and wounded hundreds.
Around the same time, the monitor said, the regime began dispatching military reinforcements to Eastern Ghouta.
Those rockets, as well as artillery fire and air strikes, killed 17 civilians, said the Observatory.
The regime is keen to regain control of Eastern Ghouta to halt the deadly salvo of rockets and mortars that rebels fire on Damascus.
About half a dozen rockets hit the capital Sunday night, AFP correspondents said. State news agency SANA reported that one person was killed.
More than 20 civilians have been killed by rebel fire this month alone in regime-held Damascus.
All was quiet in the capital yesterday but since rumours of an imminent assault on Eastern Ghouta started spreading, people living close to the rebel enclave started packing their bags.
"Were tired of this situation. It seems that there's no solution but a full-blown military one," he told AFP.
More than 340,000 people have been killed since Syria's conflict erupted in 2011 with protests against Assad's government.
It has since evolved into a war that has carved up the country into rival zones of influence among the regime, rebels, jihadists and Kurdish forces.
Turkey sees the YPG as a "terror" group linked to the Kurdistan Workers Party (PKK), outlawed by Ankara, and wants to clear it from its southern border.
The YPG has controlled Afrin since 2012, when Syrian troops withdrew from it and other Kurdish-majority areas.
Syrian state media said yesterday that pro-regime forces were preparing to enter the area to "join the resistance against the Turkish aggression".
Turkey warned against any bid by the Syrian regime to help the YPG.
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