Serena Williams has withdrawn from the Italian Open, five days after opting out of the WTA event in Madrid.
The decision puts Williams' participation at the French Open, which begins on 27 May, in doubt.
The 23-time Grand Slam champion has not played a match on clay since reaching the final at Roland Garros in 2016.
She withdrew from the Madrid Open on Thursday, stating she needs more time to prepare for her first clay season since giving birth in September.
Williams - a four-time champion in Rome - returned to the WTA tour in March.