LONDON —

       The highest-level meeting between Russia and Ukraine since the war began produced no breakthroughs Thursday as those on the ground tried to alleviate the suffering of devastated Ukrainian cities, evacuate more people to safety and assess the grim toll of a strike on a maternity hospital.

       The Russian and Ukrainian foreign ministers met in Antalya, Turkey, on the sidelines of a diplomatic conference, at the invitation of the Turkish government. After talks lasting about an hour and a half, the two sides emerged still far apart in their views of a conflict that entered its third week Thursday and that has killed hundreds, possibly thousands, of people.

       Although there was discussion of humanitarian issues, Ukrainian Foreign Minister Dmytro Kuleba said there was no progress on Kyiv’s key demand of an immediate cease-fire.

       “We can’t stop the war if the country that started the attack has no willingness to do that,” Kuleba said, adding that Moscow continued vainly to seek “a surrender from Ukraine.”

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       Kuleba noted that the encircled southern port city of Mariupol remained under incessant shelling and bombing from Russian forces, in violation of repeated agreements to allow civilians safe passage out. Mariupol officials Thursday said three people, including a child, died when a maternity hospital was hit the day before, an assault whose brutality sparked outrage around the world. Ukrainian President Volodymyr Zelensky called it a war crime.

       That toll added to the more than 1,200 people killed in Mariupol alone in the war’s first nine days, according to the city’s deputy mayor — a number that far eclipses the figure issued for all of Ukraine by the United Nations, which acknowledges its tally to be an undercount.

       A woman walks outside a maternity hospital that was damaged by shelling in Mariupol, Ukraine, on Wednesday.

       (Evgeniy Maloletka / Associated Press)

       Russian Foreign Minister Sergei Lavrov said a cease-fire was never going to be on the table in Thursday’s talks but would rather be negotiated elsewhere in the context of Moscow’s overall demands. He brushed aside criticism over the deadly strike on the hospital, calling the accusation of an atrocity another of Ukraine’s “pathetic cries.”

       He alleged that the facility had become a base for radical Ukrainian fighters, that women and children had been moved out and that Ukraine was using civilians as human shields.

       Sticking to Moscow’s narrative of the invasion that began Feb. 24, Lavrov insisted that Russia “did not attack Ukraine” but rather launched a “special military operation” — he refused to call it a “war” — because Ukraine presented “a direct threat” to his country.

       “Ukraine is being made into an anti-Russian state” through Western manipulation and intimidation, Lavrov said. He reiterated Moscow’s demand for the “de-militarization” and “de-Nazification” of a country whose army is a small fraction of the size of Russia’s and whose president is Jewish.

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       Although some observers had speculated that Thursday’s foreign ministers’ meeting could pave the way for direct talks between Zelensky and Russian President Vladimir Putin, such a summit seems a distant prospect. Lavrov said the two leaders would meet only if it could achieve “added value” beyond ongoing negotiations at lower levels.

       Far from the diplomatic wrangling in Turkey, officials in some of Ukraine’s most war-battered cities struggled to move their people to safety. Ukrainian authorities said evacuation routes from seven cities had been agreed on Thursday with the Russian side, but it was unclear whether fighting had actually halted in those so-called humanitarian corridors. Only three of six routes Wednesday were able to operate, Zelensky said.

       Heavily besieged Mariupol, whose plight has captured international attention, was once again on the evacuation list. However, Deputy Mayor Sergei Orlov said Thursday morning that the designated safe routes have been anything but.

       Smoke rises after shelling in Mariupol, Ukraine, on Wednesday.

       (Evgeniy Maloletka / Associated Press)

       Instead, Orlov told the BBC, Russian shelling had forced fleeing people to turn back — to dire living conditions he likened to those of “ancient times,” without heat, water or sanitation. In a city where two weeks ago residents gathered in cafes and restaurants and moved around freely, people are now collecting snow in subfreezing temperatures to melt for drinking water and scrounging for firewood to cook what food they have left.

       Orlov said 1,207 people in Mariupol were killed in the first nine days of the war, some of whom were recently interred in a mass grave, for lack of opportunity or resources to accord them more dignified burials. Because it has been hard to recover bodies, Orlov fears the real number of dead could be three times that figure.

       Of the enemy’s ultimate goal, “now I think his final aim is to have Ukraine without Ukrainians,” Orlov said. “He’s not fighting with [the] Ukrainian army and Ukrainian troops; he’s fighting with civil society, with all Ukraine as a nation.”

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       Russian forces pressed their offensive elsewhere, including outside the capital, Kyiv, which they appear to be preparing to surround.

       Inside the capital, there were signs of a more robust defense. Major junctions, as well as the entrances to most bridges connecting Kyiv’s two halves on each side of the Dnieper River, were blocked, many with tram carriages, buses, garbage trucks and other municipal vehicles.

       A skirmish about 20 miles northeast of Kyiv on Thursday saw a column of Russian armored vehicles try to breach the city’s defenses near a bridge on the main highway between Kyiv and the city of Chernihiv.

       By mid-morning, Ukrainian soldiers were showing off a Russian armored personnel carrier whose occupants had run away, a Ukrainian commander said. The vehicle sat on the side of the highway, its dull-green metal glinting in the cold morning sun.

       Beside it were strewn the Russian soldiers’ belongings: sleeping bags, toiletries and, oddly, a Canon printer.

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       Western analysts have warned that, despite tougher-than-expected resistance from Ukrainian forces and sanctions by the U.S. and its allies, Putin appears determined to prosecute the war until Ukraine is conquered and turned into a vassal state. That could mean a turn toward indiscriminate shelling and other devastating tactics akin to those employed by Moscow’s forces in Chechnya and Syria.

       Remarks by the Russian-backed commander of the separatist enclave of Donetsk, in eastern Ukraine, seemed to presage a more vicious phase of the war.

       The commander, Eduard Basin, told the Rossiya 24 television channel that Ukrainian forces still inside Mariupol would not be allowed to evacuate but would either have to “die or surrender.”

       “There is nowhere to push them out — only into the sea,” Basin said.

       Chu reported from London and Bulos from Kyiv, Ukraine.