The dead include at least eight children, White Helmets Syria Civil Defence says.
At least 34 people wounded as regime targets 13 populated areas in towns of Khan Shaykhoun and Marra al Numan in Idlib province countryside, the civil defense agency says.
At least 45 civilians were killed in regime attacks on Idlib between September 17 and December 24 last year, according to a Syrian Network for Human Rights report.
Russia and Turkey agreed during a summit meeting in the Black Sea resort city of Sochi on September 17 to set up a buffer zone in Idlib aimed at preventing a regime assault.
Idlib province and adjacent rural areas form the largest piece of territory still held by Syria's beleaguered opposition and rebels, worn down by a succession of regime victories in recent months.
Backed by its allies Russia and Iran, the Syrian regime has targeted several areas of Idlib with artillery and air strikes, sometimes hitting hospitals and rescue centres in the country's last major opposition and rebel-held stronghold.
As Tehran talks failed to reach consensus regarding Assad's plans to attack Idlib, locals in the region are staring at a possible bloodbath with no place to hide.
Over 3 million people live in the last major stronghold of active opposition to Bashar al Assad. The Syrian regime and Russian warplanes began air strikes in Idlib this week in a possible prelude to a full-scale offensive.
There is "evidence" that chemical weapons are being prepared by Syria in the northwest, US adviser James Jeffrey says, as the world waits for Turkey, Russia and Iran to prevent Assad's regime from launching an all-out, devastating attack on Idlib.
The Syrian regime has vowed to retake Idlib province. Turkey is warning such a move will be disastrous, while regime-backer Russia has moved 10 warships and two submarines off the coast of Syria .
The Syrian regime is gearing up for an expected offensive in Idlib province, which is home to nearly 3 million people and has a large al Qaida presence in addition to opposition and rebel groups.
Damascus and its allies continue to assault Idlib on Friday despite it being designated a ‘de-escalation zone’ in which acts of aggression are expressly prescribed. Local sources said that the strikes were carried out by the regime and Russia.
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