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(CNN) —  

Hundreds of civilians have been killed and injured in Raqqa since the offensive to recapture the Syrian city from ISIS began in June, a new report by rights group Amnesty International said Thursday.

Civilians are “coming under fire from all sides,” the report said, citing survivors’ accounts, as they find themselves trapped between ISIS booby traps and snipers, and airstrikes and artillery strikes by the US-led coalition against ISIS and Russian-backed Syrian government forces.

The rights group documents 176 cases of civilians killed in and around Raqqa in June and July, saying they constitute “a small sample of a much wider pattern.”

Its report calls on coalition forces and the US-backed Syrian Democratic Forces (SDF) to redouble their efforts to protect the thousands of civilians still trapped in Raqqa by avoiding indiscriminate or disproportionate strikes, and creating safe exit routes from the battleground.

It warns that many of those civilians are effectively being used as human shields by ISIS, which it says has used “multiple tactics” to prevent them fleeing, including laying landmines along exit routes, setting up checkpoints and firing on those caught trying to leave.

Survivors also told Amnesty International that coalition forces have been targeting boats crossing the Euphrates River, one of the only remaining ways out of the city.

A resident of Daraiya, west of Raqqa, told Amnesty International: “It was hell, many shells struck the area. Residents did not know how to save themselves. Some people ran from one place to another … only to be bombed there. Didn’t the SDF and the coalition know that the place was full of civilians? We were stuck there … because Daesh [ISIS] didn’t let us leave.”

Coalition: Costs higher if we don’t defeat ISIS

According to the latest estimate by the US-led coalition, 624 civilians in Syria and Iraq are believed have been unintentionally killed by its strikes since the start of Operation Inherent Resolve in 2014.

In response to questions from CNN, the Coalition Joint Task Force’s public affairs office said it was doing its best to limit harm to civilians. It also questioned the reliability of many reported casualty figures.

Nonetheless, as the battle for Raqqa intensifies, the coalition said, “more civilians will be at risk because ISIS holds them hostage and refuses to let them flee. If they are not liberated they will surely die at the hands of ISIS or from starvation.

“The Coalition has done, and continues to do, everything within our power to limit harm to non-combatants and civilian infrastructure. The unfortunate death of civilians is a fact of war that weighs heavy on our hearts, however, if ISIS is not defeated the cost will be even higher, and it will be paid not just in Iraq and Syria, but in our homelands across the globe.”

It added that ISIS had had up to three years to prepare its defense of cities such as Raqqa and Mosul, in Iraq, meaning that the only way to liberate them was to fight street by street, and that commanders must find a “delicate balance” between operational needs and protecting non-combatants.

’Horrific brutality’

Amnesty International said the responsibility to safeguard civilians lies on all sides.

“Those besieged in Raqqa face horrific brutality at the hands of IS – of that there is no doubt,” said Donatella Rovera, senior crisis response adviser at Amnesty International, who led the on-the-ground investigation, using an alternative acronym for ISIS.

“But violations by IS do not lessen the international legal obligations of other warring parties to protect civilians. This includes selecting lawful targets, avoiding indiscriminate or disproportionate strikes, and taking all feasible precautions to minimize harm to civilians.”

It’s not known exactly how many civilians remain trapped in Raqqa and other ISIS-controlled areas around the city.

But UN humanitarian adviser on Syria Jan Egeland called Thursday for a humanitarian “pause” in Raqqa, saying that 20,000 civilians trapped by ISIS were at risk from airstrikes, shelling and attacks on boats on the Euphrates.

Humanitarian pauses were negotiated to allow civilians to leave rebel-held areas of the besieged Syrian city of Aleppo at the end of last year. However, ISIS was not involved in that battle.