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Serena Williams, the two-time defending champion at the Internazionali BNL d'Italia, withdrew from the event ahead of her third round match on Thursday due to a right elbow injury.

"It actually started a little bit in Madrid last week," Williams said in a press conference. "I wasn't serving my best. I have to be able to serve and hit my shots with a lot of confidence, and when you're injured, you don't have that much confidence. It's so important to have it when you go up against any player out there, whether it's in my match today or in the final of a Grand Slam. You just really need it.

"It wasn't an easy decision. I talked with my coach and he said it wouldn't be very smart for me to play, and that we have to make the right decision for the future, and not for now. I told him that I hate quitting, but then he told me this isn't about quitting, it's about making the best decision."

Williams also didn't want to make the same mistake she made last year ahead of Roland Garros.

"I'm learning from bad decisions in the past, even last year," she said. "I ended up taking four days off before Paris and practiced just a day or two before the tournament started, and you never want to enter a Grand Slam under those circumstances, especially as a defending champion like I was last year."

And her prognosis for this year's French Open?

"I think if I continue to play it could get worse, and I would have a situation on my hands, so this is the mature decision," Williams said. "As soon as I've done a medical check I'll let everyone know."

Rome has always been a special tournament for Williams. She won her first clay court title here in 2002 - which you can look back on here - and she hasn't lost a match here since way back in 2010.

"I've played here 100 times and I think I've won 30 times - well, I don't know the math, but I've done really well here!" she said. "But I love Rome. I love playing in Rome. I have a lot of friends here. I love the Tournament Director. I just love being here, and pulling out of this tournament is not fun."

By virtue of the No.1-seeded Williams' withdrawal, American qualifier Christina McHale gets a walkover into the quarterfinals, where she will have an all-qualifier, all-WTA Rising Star battle with Daria Gavrilova, who defeated Timea Bacsinszky, 6-4, 7-6(0), to reach her very first WTA quarterfinal.

McHale and Gavrilova will be playing against each other for the very first time.