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RAFAH, Gaza Strip (AP) 鈥� Hamas released two elderly Israeli women held hostage in Gaza on Monday, as the United States expressed increasing concern that the escalating Israel-Hamas war will spark a wider conflict in the region, including attacks on American troops.

The death toll in Gaza rose rapidly as Israel ramped up airstrikes, flattening residential buildings in what it says was preparation for an eventual ground assault. The United States advised Israel to delay an expected ground invasion to allow time to negotiate the release of more hostages taken by Hamas during its brutal incursion two weeks ago.

A third small aid convoy from Egypt entered Gaza, where the population of 2.3 million has been running out of food, water and medicine under Israel鈥檚 two-week seal. With Israel still barring entry of fuel, the U.N. said its distribution of aid would grind to a halt within days when it can no longer fuel its trucks. Gaza hospitals flooded by a constant stream of wounded are struggling to keep generators running to power life-saving medical equipment and incubators for premature babies.

The two freed hostages, 85-year-old Yocheved Lifshitz and 79-year-old Nurit Cooper, were taken out of Gaza at the Rafah crossing into Egypt, where they were put into ambulances, according to footage shown on Egyptian TV. The two women, along with their husbands, were snatched from their homes in the kibbutz of Nir Oz near the Gaza border during Hamas鈥� Oct. 7 rampage into southern Israeli communities. Their husbands were not released.

Hamas said it had released them for humanitarian reasons, days after freeing an American woman and her teenage daughter. Hamas and other militants in Gaza are believed to have taken roughly 220 people, including an unconfirmed number of foreigners and dual nationals.

Israel is widely expected to launch a ground offensive in Gaza, vowing to destroy Hamas. Iranian-backed fighters around the region are warning of possible escalation if that happens, including targeting U.S. forces deployed in the Mideast.

The U.S. has told Iranian-backed Hezbollah in Lebanon and other groups not to join the fight. Israel and Hezbollah have traded fire almost daily across the Israel-Lebanon border, and Israeli warplanes have struck targets in the occupied West Bank, Syria and Lebanon in recent days.

National Security Council spokesman John Kirby said there had been an uptick in rocket and drone attacks by Iranian-backed militias on U.S. troops in Iraq and Syria, and the U.S. was 鈥渄eeply concerned about the possibility for any significant escalation鈥� in attacks in coming days.

The U.S. advised Israeli officials that delaying a ground offensive would give Washington more time to work with regional mediators on securing the release of more hostages, according to a U.S. official.

Israeli tanks and ground forces have been massed at the Gaza border, and Defense Minister Yoav Gallant told troops there Monday to keep preparing for an offensive 鈥渂ecause it will come.鈥� He said it would be a combined offensive from air, land and sea but did not give a timeframe.

A ground offensive is likely to dramatically increase casualties in what is already the deadliest by far of five wars fought between Israel and Hamas since the militant seized power in Gaza in 2007.

More than 1,400 people in Israel have been killed 鈥� mostly civilians slain during the initial Hamas attack. At least 222 people were captured and dragged back to Gaza, including foreigners, the military said Monday, updating a previous figure.

Realted news: The father of American teenage hostage freed by Hamas says she is 鈥榙oing very good鈥�

More than 5,000 Palestinians, including some 2,000 minors and around 1,100 women, have been killed, the Hamas-run Health Ministry said Monday. That includes the disputed toll from an explosion at a hospital last week. The toll has climbed rapidly in recent days, with the ministry reporting 436 additional deaths in just the last 24 hours.

Israel said it had struck 320 militant targets throughout Gaza over the last 24 hours. The military says it does not target civilians, and that Palestinian militants have fired over 7,000 rockets at Israel since the start of the war.

Israel carried out limited ground forays into Gaza. On Sunday, Hamas said it destroyed an Israeli tank and two armored bulldozers inside Gaza. The Israeli military said a soldier was killed and three others were wounded by an anti-tank missile during a raid inside Gaza.

On Monday the Palestinian Red Crescent said 20 trucks entered Gaza carrying food, water, medicine and medical supplies, through the Rafah crossing with Egypt, the only way into Gaza not controlled by Israel. It was the third delivery in as many days, each around the same size.

The aid coming in so far is 鈥渁 drop in the ocean鈥� compared to the needs of the population, said Thomas White, the Gaza director of the U.N. agency for Palestinian refugees.

White said the agency had only three days of fuel left for its trucks. The supplies coming through Rafah are reloaded onto U.N. and the Red Crescent trucks to take to hospitals and U.N. schools in the south of Gaza, where hundreds of thousands of people are taking shelter, running low on food and largely drinking contaminated water.

At least 1.4 million Palestinians in Gaza have fled their homes, and nearly 580,000 of them are sheltering in U.N.-run schools and shelters, the U.N. said Monday.

No aid will be distributed in Gaza City and other parts of the north, where hundreds of thousands of people remain. Gaza City鈥檚 main al-Shifa Hospital, with a normal capacity of 700 patients, is currently overwhelmed with 5,000 patients, and around 45,000 displaced people are gathered in and around its grounds for shelter, the U.N. said.

鈥淭he north didn鈥檛 receive anything鈥� from incoming aid, said Mahmoud Shalabi, an aid worker with Medical Aid for Palestinians aid group based in the northern town of Beit Lahia. 鈥淚t鈥檚 like a death sentence for the people in the north of Gaza.鈥�

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Magdy reported from Cairo and Krauss from Jerusalem. Associated Press writers Wafaa Shurafa in Deir al-Balah, Gaza Strip, Aamer Madhani in Washington, Amy Teibel in Jerusalem, Brian Melley in London, contributed to this report.