Iran has warned the scale of civilian suffering caused by Israel's war on Hamas would inevitably lead to an expansion of the conflict, as officials in Gaza reported Israeli air strikes on or near several hospitals in the Palestinian enclave.

The comments from Iranian Foreign Minister Hossein Amir-Abdollahian could ramp up concerns over whether Iran or Iran-aligned groups such as Hezbollah in Lebanon and the Houthi movement in Yemen will fully enter the conflict.

"Due to the expansion of the intensity of the war against Gaza's civilian residents, expansion of the scope of the war has become inevitable," Amir-Abdollahian told his Qatari counterpart Sheikh Mohammed Bin Abdulrahman Al Thani on Thursday night. Iran's state-run Press TV reported the comments on Friday.

Israel's bombardment and siege of Gaza over the past month have created a humanitarian catastrophe with thousands seeking medical treatment and shelter in the few hospitals still open, with those in the combat zone operating in grave danger.

"The Israeli occupation launched simultaneous strikes on a number of hospitals during the past hours," Gaza's Ministry of Health spokesman Ashraf Al-Qidra told Al Jazeera television.

Qidra said an Israeli strike hit a courtyard in the Al Shifa hospital, the biggest in Gaza City, causing casualties, but he did not provide details. Israel said Hamas has hidden command centers and tunnels beneath Al Shifa, and other hospitals such as the Indonesian Hospital – allegations that Hamas denies.

"While the world sees neighborhoods with schools, hospitals, scout groups, children's playgrounds and mosques, Hamas sees an opportunity to exploit," Israel's military said in a statement.

Iran supports Hamas but says it did not play any role in the militants' bloody attack on Israel last month that triggered the crisis.

In northern Gaza, Israel has agreed to pauses in its offensive that will allow some civilians to flee heavy fighting, but Prime Minister Benjamin Netanyahu ruled out any broader ceasefire as a "surrender" to Hamas.

U.S. President Joe Biden welcomed the pauses, which formalize an arrangement that has already seen tens of thousands of Palestinians flee devastation in northern Gaza, but also said there was "no possibility" of a ceasefire.

Netanyahu said Israeli troops were performing "exceptionally well" in the offensive, which came after Israel's Tuesday statement that its forces were operating in the heart of Gaza City, the stronghold of Hamas militants. 

Tens of thousands of civilians have streamed out of northern Gaza in recent days, with men, women and children clutching meager possessions as they emerge from the devastated war zone.

They have fled as the warring sides engaged in intense close-quarters fighting, with Hamas militants using rocket-propelled grenades against Israeli troops backed by armored vehicles.

The UN agency responsible for Palestinian refugees, UNRWA, said some 70,000 people had traveled south on the route since November 4, most of them walking.

Almost 1.6 million people have been internally displaced since October 7.

But the UN estimates hundreds of thousands of civilians remain in the fiercest battle zones in the north.

(With input from AFP, Reuters)