US Secretary of State John Kerry has warned his Russian counterpart that Washington will end Syria talks unless Moscow stops the bombing of Aleppo.
In a phone call with Sergei Lavrov, Mr Kerry said the US held Russia responsible for the use of incendiary and bunker bombs against the city.
The US state department said it was making preparations to suspend talks.
Aleppo has come under heavy aerial bombardment since the end of a ceasefire a week ago.
Some 250,000 people are trapped in the rebel-held east of the city. They are under siege from Russian-backed Syrian government forces, which have launched a fierce campaign to recapture the area. The bombardment has been among the worst in the history of the five-year conflict.
The US has accused Russia of taking part in strikes on civilian targets and possibly committing war crimes.
The two nations have been locked in talks in an attempt to revive a fragile peace agreement, but the US said last week that Russia had openly lied to the UN about its intentions.
'Living nightmare'
At least 96 children have been killed and 223 injured in eastern Aleppo since Friday, according to the UN children's agency Unicef.
"The children of Aleppo are trapped in a living nightmare," said Unicef deputy executive director Justin Forsyth on Wednesday. "There are no words left to describe the suffering they are experiencing."
More than 170 people have been killed in east Aleppo since the beginning of the recent offensive, according to the UK-based Syrian Observatory for Human Rights, a monitoring group.
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