ROME (AP) Madison Keys is still struggling to regain her form after left wrist surgery.
The 13th-ranked American was beaten by Australian qualifier Daria Gavrilova 2-6, 7-5, 7-5 on Tuesday in the first round of the Italian Open - a tournament in which she reached the final last year.
Keys was operated on during the offseason and missed the opening two months of the year. She also had opening-round losses in her previous two tournaments in Charleston, South Carolina, and Madrid.
The 33rd-ranked Gavrilova had to come through qualifying because she forgot to enter the main draw.
Gavrilova broke Keys' serve at love to take a 6-5 lead in the third set then hit an ace on her second match point.
Also, fifth-seeded Johanna Konta defeated Yulia Putintseva 6-3, 6-0; Ekaterina Makarova eliminated Roberta Vinci 6-2, 6-1; and qualifier Catherine Bellis beat Misako Doi 6-4, 7-6 (6).
In men's action, 13th-seeded Jack Sock defeated Diego Schwartzman 6-4, 1-6, 7-5.
Nick Kyrgios withdrew from the tournament with a hip injury.