The rescue service, a volunteer relief group formally known as the Syrian Civil Defense, said the raid had targeted a residential building in Atmeh, a village in northern Syria near the Turkish border. The area is home to a number of camps for those displaced by the country’s long-running civil war.

The Syrian Observatory for Human Rights, a Britain-based opposition war monitor, also said the strike killed at least 13 people, including four children and three women.

Residents and activists in the area described seeing a large ground assault, and U.S. forces using loudspeakers asking women and children to leave the area, The Associated Press reported.

In photos following the raid, first responders could be seen retrieving bodies as others surveyed the damage, with the roof of a building partially collapsed and surrounded by rubble.

Images that appeared to be taken from inside the building showed belongings strewn across the floor, including a pink glittery shoe that appeared to belong to a small child.

Syria has been gripped by over a decade of war, with the United Nations’ human rights office warning in September the conflict had already left more than 350,000 people dead, calling the figure “an undercount.”

The U.S. has previously used drones to target top Al Qaeda figures in Idlib, once home to many of the group’s leaders. The Pentagon has accused the group of using Syria as a base for threats within the country, as well as in neighboring Iraq and beyond.

The latest operation appears to be one of the largest in northwestern Syria since Islamic State group leader Abu Bakr al-Baghdadi died during a special forces raid in October 2019.

American forces have continued to conduct airstrikes in Syria since then, including last year.

In October, a U.S. airstrike in the area killed a senior Al Qaeda leader, Abdul Hamid al-Matar, in an effort that the U.S. Central Command said would disrupt the group’s “ability to further plot and carry out global attacks threatening U.S. citizens, our partners, and innocent civilians.”

In December the U.S. and its military allies shot down a drone believed to pose a threat to a U.S. outpost in southern Syria, just weeks after the base was attacked by drones and rocket fire.

Ziad Jaber contributed.