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By Halimah Abdullah

The U.S. Central Command said Friday that an additional 20 civilians were killed in American airstrikes in Iraq and Syria between September and early February—a figure which brings the total number of innocent civilians believed killed by U.S. airstrike to 41 since airstrikes began two years ago.

In addition 12 civilians were reported wounded in the strikes. U.S. military officials stress that these numbers are assessments only and that the actual number of civilians killed could be more or less.

An employee of Doctors Without Borders walks inside the charred remains of their hospital on Oct. 16, 2015, after it was hit by a U.S. airstrike in Kunduz, Afghanistan.Najim Rahim / via AP

"There is always a risk" for civilian casualties but there are never any "intentional airstrikes" aimed at civilians, CENTCOM public affairs officer Col. Pat Ryder told reporters Friday.

Related: MSF-Supported Clinic in Syria Destroyed by Airstrike, Doctors Without Borders Says

Despite the increase in the rate of civilian casualties in the latest four-month assessment, U.S. military officials insist the overall number of civilian casualties is "low."

Ryder claims the estimated number of 41 civilians killed "is a testament to the accuracy and precautions of US airstrikes."

Ryder added that while the U.S. military takes every possible precaution to avoid civilian deaths he blames ISIS for positioning many of its fighters and weaponry which are likely targets for airstrikes among the innocent civilian population.

Doctors Without Borders workers walk through the aftermath of the U.S. airstrike on the hospital in Kunduz, Afghanistan that that killed 22 people on Oct. 14. The U.S. military has taken responsibility for the Oct. 3, attack.Victor J. Blue / for NBC News

Amnesty International questioned the figures on Friday.

“Those are really low numbers for two years of airstrikes,” said Naureen Shah, director of Security with Human Rights at Amnesty International USA. “We have serious concerns about the department of defense records of acknowledging and investigating civilian casualties overall.”

The organization said it worries that such military reviews are not independent and therefore questionable.

“That leads me to have skepticism and concerns when the U.S. puts forth low casualty rates,” she said.