Heavy bombardments of suspected insurgent positions took dozens of lives in two Iraqi towns on Thursday, the US military has said.
Women and children were reportedly pulled from the rubble of the Falluja strike
An offensive by US and Iraqi forces in the northern town of Talafar killed as many as 57 insurgents, it said.
Hospital sources told AFP news agency that 45 bodies had been admitted, plus 80 wounded, including the deputy mayor.
In Falluja in central Iraq, at least nine were reported killed in US attacks on an alleged militant safe house.
The BBC's Caroline Hawley in the capital Baghdad says Talafar and Falluja are among several towns in Iraq now controlled by rebels.
The US says Talafar is a haven for fighters who have entered Iraq from Syria, 100km (60 miles) away.
Joint US and Iraqi forces launched a bombardment of the town in the early hours of Thursday morning. It was variously described as lasting between seven and 13 hours.
"The operation comes after MNF [multinational forces] and Iraqi security forces were repeatedly attacked by a large terrorist element that has displaced local Iraqi security forces throughout recent weeks," the US military said in a statement.
US operations have targeted the town over the past week.
"The situation is critical," said provincial health director Rabee Yassin. "Ambulances and medical supplies cannot get to Talafar because of the ongoing military operations."
In Falluja, west of Baghdad, the US said it had attacked a site used by supporters of the Jordanian militant, Abu Musab al-Zarqawi, who the Americans say is an important member of al-Qaeda.
However, several women and children were among the dead and wounded pulled from the rubble, doctors said.
The US military has been fighting insurgents in the town for several days, since a car bomb there killed seven of its marines on Monday.
Coalition forces lost control of Falluja in April after turning it over to a local force, the Falluja Brigade. That force is reported to have disappeared, and the town is said to have fallen into rebel hands.
However, there appeared to be more success for the US and Iraqi authorities in Samarra, a town 100km north of Baghdad that has been a Sunni insurgent stronghold.
Under a deal with local leaders, US troops entered the town for the first time since June.