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The director of the main hospital in the city said at least 450 Iraqis had been killed and more than 1,000 wounded in fighting in the city since the marine offensive began on Monday.

During a lull in fighting yesterday, hundreds of women and children fled the city.

Vehicles queued at one checkpoint, but many men trying to leave with their families were told they could not go, and whole families were turned back.

"A lot of the women were crying," said Lance Corporal Robert Harriot, 22, of Eldred, New York. "There was one car with two women and a man. I told them that he couldn’t leave. They tried to plead with me. But I told them no, so they turned around."