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Russian attacks left Ukraine's southeastern regions of Dnipropetrovsk and Zaporizhzhia almost entirely without power, the country's energy ministry said on Wednesday night.
Critical infrastructure was "operating on reserve power", it said in a statement on Telegram, while officials said water supplies and the internet were also disrupted.
Russia has recently intensified attacks on Ukraine's energy infrastructure, aimed at paralysing power supplies during a harsh winter.
"Ukraine's energy system is under enemy attacks every day, and energy workers are operating in extremely difficult conditions to provide people with light and heat," Ukraine's Prime Minister Yulia Svyrydenko wrote on Telegram.
"Deteriorating weather conditions put additional strain on critical infrastructure," she said.
The disruptions to power and heating have come as temperatures plunge.
"Emergency restoration work in the regions affected by the attack will begin immediately as soon as the security situation allows," state energy company Ukrenergo said on Telegram.
It added: "The primary task of energy workers is to restore critical infrastructure."
Dnipro city Mayor Borys Filatov said on Telegram all city hospitals had been completely switched to generators.
"There are the necessary water supplies, the treatment process does not stop. Water drainage in houses is also supported by alternative power sources," Filatov said.
School holidays had been extended until 9 January because of the power cuts, he added.
The head of the Zaporizhzhia regional administration, Ivan Fedorov, said everything possible was being done to restore power.
"At this time, water utility workers have almost restored water to our homes, despite the fact that there is a complete blackout in the region," Fedorov said in a video message published on Telegram.
DTEK, Ukraine's biggest private energy provider, is living in permanent crisis mode because of Russian attacks on the grid, its chief executive told the BBC last month, with most of Ukraine suffering from lengthy power cuts during winter.
Maxim Timchenko, CEO of DTEK, which provides power for 5.6 million Ukrainians, said the intensity of strikes had been so frequent "we just don't have time to recover".
As the fourth anniversary of Russia's full-scale invasion approaches, Timchenko said Russia had repeatedly targeted DTEK's energy grid with "waves of drones, cruise and ballistic missiles" and his company had found it difficult to cope.
The attacks come as Ukrainian President Volodymyr Zelensky said European allies have not given him sound guarantees that they will protect his country in the event of new Russian aggression.
Following talks in Paris on Tuesday, the UK and France signed a declaration of intent on deploying troops in Ukraine if a peace deal is made with Russia.
Moscow has repeatedly warned that any foreign troops in Ukraine would be a "legitimate target".

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